OBJECTIVES: The Institute for Clinical and Economic Review’s (ICER) 2023 updated value assessment framework aims to improve health equity outcomes through the use of new assessment methodologies. In March 2023, ICER published a white paper with specific recommendations for addressing health equity concerns in health technology assessments (HTAs) and committed to immediately incorporating these methods in its assessments. This research examines how ICER has incorporated health equity factors in their final evidence reports since the release of their white paper.

METHODS: All of ICER’s available final (n=3) evidence reports published on or after 03/15/2023 were reviewed. We extracted all health equity measures ICER incorporated into their assessments, with a particular focus on measures outlined in their white paper.

RESULTS: Qualitatively, ICER most consistently included discussion of health disparities in the report background, evidence of engagement with a diverse patient population during scoping, and inclusion of health equity considerations in criteria for appraisal committee voting. All final evidence reports included voting on society’s goal of reducing health inequities. ICER’s policy roundtable discussions made health equity recommendations most frequently to manufacturers and payers. Quantitatively, 1 of 3 final evidence reports included participant to disease-prevalence representation ratio and subgroup analyses using the ICER clinical trial diversity rating tool. A health improvement distribution index score was calculated and included in 2 of 3 final evidence reports. No final reports included a distributional cost-effectiveness analysis or multicriteria decision analysis.

CONCLUSIONS: Although these results are preliminary and the limited number of assessments restricts the scope, ICER has made progress in incorporating new HTA methods in their assessments. There remains an opportunity for ICER to ensure both qualitative and quantitative measures related to health equity are consistently incorporated across all evidence reports.