OBJECTIVES: ICER reports rely on a value assessment framework (VAF) methodology, which is periodically updated. With ICER’s 2023 update and forthcoming white paper on assessment methodologies to support health equity goals, there is an opportunity to evaluate the role of health equity in past ICER reports, informing the appropriate role and methodologic changes to support health equity in future reports. This research aims to determine how the role of health equity factors in ICER’s Final Evidence Reports has evolved over the past 5 years.

METHODS: All Final Evidence Reports published before 08/01/22 under ICER’s 2017-2019 (n=22) and 2020-2023 (n=19) VAFs were exploratorily reviewed. We extracted equity-related text throughout reports, with a particular focus on the “Contextual Considerations and Potential Other Benefits” section. We identified the methods ICER used to consider the equity impacts of an intervention, through which we identified ICER-noted barriers to the provision of equity.

RESULTS: Equity barriers were more frequently identified in 2020-2023 reports (socioeconomic: 58% vs 41%; race: 42% vs 27%; geographic: 42% vs 23%; disease-related: 21% vs 14%; gender: 11% vs 5%). ICER appraisal panels voted on the impact of an intervention on reducing health inequities more frequently under the 2020-2023 VAF (75% vs 61%). ICER’s policy roundtable discussions under the 2020-2023 VAF increasingly called upon all stakeholders to address health equity (53% vs 0%). Quantitatively, equity-related analyses, including Health Improvement Distribution Index calculations, were more common in 2020‑2023 (16% vs 5%). Only 1 equity-related scenario analysis that determined an intervention’s cost-effectiveness was conducted.

CONCLUSIONS: The role of health equity remains predominately qualitative in ICER reports. Although its overall consideration has increased, there is still room for improvement, particularly in increasing equity-related quantitative analyses. In its upcoming VAF update, ICER has the opportunity to advance the methods by which they support society’s goal of reducing health inequities.