ICer

ICER is an acronym that can refer to two related concepts in healthcare: the incremental cost-effectiveness ratio, a statistic used in cost-effectiveness analysis, and the Institute for Clinical and Economic Review, a nonprofit American research organization that evaluates the value of medical treatments and tests.

Incremental cost-effectiveness ratio (ICER) is defined as the difference in costs between two interventions divided by the difference in their health effects, usually expressed as cost per quality-adjusted life year (QALY) gained. It is used in health technology assessment to compare the value of competing options and inform decision making by clinicians, patients, and payers. Thresholds for what is considered cost-effective vary by country and context, and ICERs can be sensitive to the choice of time horizon, discount rates, and the measurement of health outcomes. Limitations include dependence on model assumptions, uncertainties in data, and the fact that ICER measures value rather than clinical effectiveness alone.

Institute for Clinical and Economic Review (ICER) is a nonprofit research organization based in the United States. It conducts independent evaluations of the clinical and economic value of medical tests, treatments, and delivery-system innovations. ICER uses a transparent process that typically includes systematic literature reviews, economic modeling, and stakeholder input to produce value assessments and public-facing reports. The organization aims to inform clinicians, policymakers, and payers about the potential value of health interventions; it does not set policy or make coverage decisions on its own, though its work can influence payer formulary determinations and clinical guidelines.

Critics and proponents engage with ICER's methods around topics such as QALY judgments, threshold choices, and the influence of economic modeling on pricing and access.