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CADTH » Search All Products » Environmental Scanning » Health Technology Update » Issue 9 - September 2008 » Health Technology Assessment South of the Border

Health Technology Assessment South of the Border

When Dr. Steve Pearson finished his policy studies at the UK National Institute for Health and Clinical Excellence, he wondered how he could apply what he learned back home.

For him, home is the US, where examining costs and the cost-effectiveness of health interventions is traditionally overlooked or resisted.

In 2006, Dr. Pearson received funding to support the creation of the Institute for Clinical and Economic Review (ICER). The institute produces appraisals of the clinical effectiveness and cost-effectiveness of medical innovations, with the goal of providing new information to decision makers who are intent on improving the value of health care services.

ICER has evolved its efforts into an open and transparent process guided and supported by stakeholders in health care delivery. To date, ICER has produced two technology assessments and appraisals and has prioritized three additional assessments. ICER appraisals involve a comprehensive look at how coverage decisions impact health and resources.

ICER is already showing signs that it is making inroads into an environment that does not traditionally embrace HTA. In January 2008, the ICER appraisal of CT colonography (virtual colonoscopy) was presented to the Washington State Health Care Authority and used as the basis for its coverage decision for the state Medicaid program, Veterans Affairs, state employees, and Department of Corrections. The Washington State Health Care Authority voted that its judgment concurred with the ICER rating of comparative clinical effectiveness: Although CT colonography was judged to have a similar clinical impact to optical colonoscopy, coverage was denied on the basis of poor comparative value.

In February 2008, Dr. Pearson presented an overview of ICER to CADTH staff. He has since presented at the 13th annual meeting of the International Society for Pharmacoeconomics and Outcomes Research (May 2008) and was most recently an invited plenary speaker at the 5th Annual Health Technology Assessment International Meeting (July 2008). His published work includes the book No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence, published in 2003 by Oxford University Press.