Best Practices for Interacting with ICER

A systematic review of ICER evaluations from 2008 to 2018: recent trends in evaluation process and lessons learned

Ronquest NA, Gould IG, Barnett CL, Mladsi DM


The Institute for Clinical and Economic Review, or ICER, is an independent, non-partisan research organization, specializing in evaluating the value of health technologies in the US.  In a recent study, the majority of payers interviewed reported they would use an ICER cost-effectiveness threshold price as a basis for negotiating contracts.

However, despite the growing influence of ICER in the US, best practices for engaging with ICER have not been established. 

To answer the question of how to effectively communicate scientific evidence of health technologies to ICER, we have reviewed key changes in assessment processes and topic selections in the past 10 years. For the 2018 assessments, we reviewed stakeholder comments and responses from ICER as well.    

We found that the ICER review process has become more transparent and collaborative. Opportunities for public comments were introduced in 2011. The open input period, where stakeholders provide relevant data, was introduced in 2016. 

We found that most of the comments that resulted in revised base-case analyses were recommendations to use specific data or methods and concluded that it is crucial for stakeholders to provide solution-oriented guidance in their public comments.

Click on this link to see the research poster containing more detailed information about this review.