How We Do our Work

ICER is driven by a mission to conduct evidence-based reviews of health care interventions, such as drug, devices and diagnostics, that help patients, doctors, and everyone else in the health care system know what works.  For every report, ICER follows a process that includes numerous opportunities for stakeholders to engage and be involved throughout its development.

Topic Selection

The assessment process begins with topic selection.

  • For drug topics, in addition to receiving recommendations from the public, ICER scans publicly available information and also benefits from a collaboration with IPD Analytics, an independent organization that performs analyses of the emerging drug pipeline for a diverse group of industry stakeholders, including payers, pharmaceutical manufacturers, providers, and wholesalers. IPD provides a tailored report on the drug pipeline on a courtesy basis to ICER but does not prioritize topics for specific ICER assessments.
  • For non-drug topics, ICER takes recommendations from the public and also solicits suggestions from members of the Advisory Boards of our three independent appraisal committees (CTAFMidwest CEPAC, and New England CEPAC).

To make a topic suggestion, fill out our topic suggestion form with your name, contact information, and brief description of the topic you would like to suggest.

When choosing a topic, ICER considers a list of key criteria to ensure that the topics being reviewed will have meaningful impact.

Report Development

After choosing a topic, report development begins. Reports are developed in several phases with numerous opportunities for public input. For a more detailed explanation, and to learn more about how you can contribute, see our methods for stakeholder engagement.

  • After finalizing the scope of a report, ICER develops a research protocol and model specifications that are shared publicly on the Open Science Framework website. Protocols and model specs for past projects can be found here. Public posting of protocols is part of ICER’s larger commitment to economic model transparency.
  • During the development of its reports, ICER speaks with clinical experts, patients and patient groups, manufacturers, payers, and other stakeholders. In line with our commitment to transparency, every organization or individual that provides input or feedback on an ICER report is listed in the report itself, with appropriate disclaimers that the reports’ contents and conclusions are solely those of the ICER team and affiliated researchers.
  • While ICER frequently limits reviews to include only publicly available, peer-reviewed literature, there are cases where it is appropriate to consider other sources. More information about ICER’s use of “grey literature” is available here.
  • Manufacturers or other stakeholders  may have evidence that they would like to share with ICER to help ensure that reviews contain the best possible information, but sometimes this information may need to be treated as confidential, either for business or academic reasons. Read more about ICER’s policy on in-confidence data here.
  • When assessing the quality of evidence available on the topic, ICER relies on the Evidence Rating Matrix. Fundamentally, the evidence rating reflects a judgment of two critical components:
    • The magnitude of the difference in ‘net health benefit’ (or, the balance between the clinical benefits the drug offers in relation to the risks or side effects someone might experience from the drug), and
    • The level of certainty that you have in your estimate of net health benefit, based on the evidence available.
  • ICER’s Guide to Health Technology Assessment provides background on the principles behind health technology assessment. The Guide to ICER’s Methods for Health Technology Assessment provides additional detail on ICER’s methodology.
  • To encourage consistency in analytic approaches when modelling, ICER has defined a Reference Case specifying the approach that ICER and its collaborators follow for cost-effectiveness analyses.
  • In assessing value, ICER relies on the ICER Value Assessment Framework. The framework, developed with input from patient advocates, clinical societies, life science companies, pharmaceutical benefit managers, and insurers, identifies the key domains that factor into considerations of value. Learn more about the value assessment framework and its components here.

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