Incremental cost-effectiveness ratio (ICER)
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Extra cost per extra unit of health (often per QALY) of a treatment compared with the alternative.
LaTeX: ICER = \frac{C_1 - C_0}{E_1 - E_0}
Variables and notation#
C1−C0 is incremental cost and E1−E0 incremental health benefit of intervention 1 versus comparator 0; ICER is their ratio.
Worked example#
An additional cost of 1,000 and gain of 0.05 QALYs give ICER=1,000/0.05=20,000 per QALY.
Related methods and when to use them#
ICER is a cost per incremental benefit; net monetary benefit converts benefit using a stated willingness-to-pay threshold. Negative ratios are ambiguous without the cost/effect quadrant; dominance should be checked separately.
Sources and further reading#
Key findings#
- Incremental cost-effectiveness ratio (ICER) was mentioned in 26 papers in the last 30 days (2026-10-07 to 2026-11-05), ranking #60 of the 248 equations and models mentioned.
- By journal category: Health Economics and Policy (26).
- Most of them appeared in The European Journal of Health Economics (6), Cost Effectiveness and Resource Allocation (6) and PharmacoEconomics - Open (5).
- Often mentioned together with Quality-adjusted life year (QALY) (17), Decision tree (CART) (4) and Disability-adjusted life year (DALY) (2).
- Datasets named in the same papers: Global Burden of Disease (3), WITS / TRAINS tariff data (2) and China Household Finance Survey (CHFS) (1).
- From Nov 2023 to Oct 2026, 536 archived papers mentioned Incremental cost-effectiveness ratio (ICER) in their title, abstract, keywords or full text, most of them in Oct 2026 (30).
- From 2017 to 2026 (so far), Incremental cost-effectiveness ratio (ICER) was mentioned in 946 papers in the tracked journals, most of them in health economics and policy (933), statistics (8) and operations research (3).
- 167 of them were published in 2025, against 37 in 2017.
- Since 2023, the institutions with the most of these papers were University of York (29), Erasmus University Rotterdam (21) and University of Groningen (20).
- The journals publishing most of them were Cost Effectiveness and Resource Allocation (152), PharmacoEconomics (118) and PharmacoEconomics - Open (99).
- The most-cited of them is “Perspective and Costing in Cost-Effectiveness Analysis, 1974–2018” (PharmacoEconomics, 2020), with 279 citations.
Mentions over 36 months#
| Trend | Nov 23–Oct 24 | Nov 24–Oct 25 | Nov 25–Oct 26 | 36 months |
|---|---|---|---|---|
| 161 | 146 | 229 | 536 |
Papers per year#
20172026 (so far)
| Category | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 | 2026 (so far) |
|---|---|---|---|---|---|---|---|---|---|---|
| Health Economics and Policy | 35 | 58 | 56 | 47 | 68 | 68 | 99 | 149 | 166 | 187 |
| Statistics | 2 | 0 | 0 | 2 | 0 | 0 | 0 | 1 | 1 | 2 |
| Operations Research | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 0 | 0 |
| AI | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 |
| Economics | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 |
| All categories | 37 | 58 | 56 | 49 | 70 | 68 | 99 | 153 | 167 | 189 |
Where the papers come from#
| # | Journal | Papers |
|---|---|---|
| 1 | Cost Effectiveness and Resource Allocation | 152 |
| 2 | PharmacoEconomics | 118 |
| 3 | PharmacoEconomics - Open | 99 |
| 4 | Health Economics Review | 67 |
| 5 | Applied Health Economics and Health Policy | 66 |
| 6 | The European Journal of Health Economics | 58 |
| 7 | Implementation Science | 15 |
| 8 | Social Science & Medicine | 6 |
| 9 | Health and Quality of Life Outcomes | 6 |
| 10 | Health Policy and Technology | 4 |
| # | Institution | Papers |
|---|---|---|
| 1 | University of York | 29 |
| 2 | Erasmus University Rotterdam | 21 |
| 3 | University of Groningen | 20 |
| 4 | Monash University | 19 |
| 5 | University of Sheffield | 19 |
| 6 | University Medical Center Groningen | 18 |
| 7 | Harvard University | 17 |
| 8 | University of Oxford | 17 |
| 9 | Karolinska Institutet | 14 |
| 10 | London School of Hygiene & Tropical Medicine | 14 |
| # | Country | Papers |
|---|---|---|
| 1 | United Kingdom | 163 |
| 2 | United States | 120 |
| 3 | Netherlands | 77 |
| 4 | China | 68 |
| 5 | Australia | 67 |
| 6 | Germany | 46 |
| 7 | Switzerland | 44 |
| 8 | Canada | 41 |
| 9 | Spain | 32 |
| 10 | Sweden | 28 |
| # | Keyword | Papers |
|---|---|---|
| 1 | cost-effectiveness | 436 |
| 2 | quality-adjusted life years | 295 |
| 3 | incremental cost-effectiveness ratio | 132 |
| 4 | Markov model | 89 |
| 5 | health technology assessment | 80 |
| 6 | willingness-to-pay threshold | 60 |
| 7 | cost-utility analysis | 59 |
| 8 | health care costs | 54 |
| 9 | economic evaluation | 44 |
| 10 | health-related quality of life | 37 |
Most-cited papers#
Cite this page
Scholar4AI. (2026). Incremental cost-effectiveness ratio (ICER). Journal and Conference Research Rankings. Retrieved November 5, 2026, from https://scholar4ai.com/equations/incremental-cost-effectiveness-ratio-icer
@misc{scholar4ai-equations-incremental-cost-effectiveness-ratio-icer,
author = {{Scholar4AI}},
title = {Incremental cost-effectiveness ratio (ICER)},
year = {2026},
howpublished = {\url{https://scholar4ai.com/equations/incremental-cost-effectiveness-ratio-icer}},
urldate = {2026-11-05},
note = {Journal and Conference Research Rankings; data from OpenAlex (CC0); licensed CC BY-NC 4.0}
}