We recognize that there are three dimensions to health care – quality, access, and affordability. The problem facing all societies is how to balance the three. This is what LSPOR is about – the trade-offs and compromises to maximize quality care, accessibility for all, and affordability. These trade-offs are a great challenge for all stakeholders. LSPOR is an organization that exists to help meet this challenge by working together with payers demanding greater evidence of value; and helping to establish what is feasible, given data, costs, and the science, to improve methods, the evidence base, and decision making, over time.