Patient Open Input Questionnaire

Patient Guide to Open Input

We want to hear from you

When starting a new report, we have a lot of questions. What treatments should we include? What outcomes should we consider? What are we missing? We need help answering these questions. We look to all kinds of groups- doctors, drug makers, insurance companies, and, importantly, patients—to help us fill in the gaps.

That’s where you come in. By providing us with information about how patients experience their disease and what is most important to them, you help us to make sure we’re thinking about these issues from the very beginning. It’s important to us that we know what matters to you—the patient—to make sure our reports can support policies and guidelines that help make sure patients can access, and afford, the most effective treatments.

Sending your input

The questions below can help give you an idea of what kinds of information are most helpful to our reports. You can answer as many or as few of the questions as you’d like. There are no page limits to Open Input submissions. Anything you can tell us about your experience is very helpful and important in helping us create a useful report.

  • To give us time to consider your input, we’ll need to receive your answers by the deadline. Open Input lasts for three weeks. You can find the deadline on the “Meeting” page of the specific topic you’d like to comment on.
  • Use the below form to submit your responses directly, or email your responses, and any other information or documents, to We’ll confirm that we’ve received it.

The deadline for Open Input often closes just before the draft scoping document is set to post. Input submitted towards the end of the open input period may not be considered in time for the draft scoping document posting, but will be reviewed and incorporated into a revised scoping document and throughout the report process. Information received during this period is helpful at all phases of report development.

You acknowledge that you are not required to provide information to ICER and that you are doing so voluntarily.  Please see our Terms of Use and Conditions and our Privacy Policy to review how we use and disclose information submitted to us.  While we do not plan to publish information that identifies a particular individual, we intend to use the information submitted as part of our drug reviews.  We recognize that submissions sometimes contain specific medical information that might raise concerns about appropriateness of treatment, physical or mental health, and safety.  The use of this site, and information submitted to ICER, should not take the place of professional medical care.  ICER does not diagnose health problems or provide treatment advice.  The completion of this questionnaire does not trigger any patient-provider relationship.  Any information found on this site, or inferred from this survey, should in no way be considered medical advice or a plan for health management.  Anyone seeking or needing immediate medical treatment is advised to contact their health care provider or visit an emergency room.

Patient Open Input Questionnaire

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