Abstract: The Institute for Clinical and Economic Review (ICER) fills a unique role in the U.S. health care landscape. As it passes its 15^th year in operation, ICER’s impact has never been greater, yet significant obstacles still remain. What have been the lessons learned about conducting and communicating cost-effectiveness analyses for decision-makers in the U.S.? Steve Pearson, the Founder of ICER, will address this question and share his vision for the future.