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This article is part of a Health Affairs Forefront short series, “Enhancing Value By Evaluating Health Care Services.” The series discusses ways to extend the use of tools for clinical and economic evaluation beyond medical technologies to the services and procedures that account for the bulk of health care spending; the goal is to create a more robust evidence base for the effectiveness and value of health care services. The articles in the series were completed with support for the authors from the Research Consortium for Health Care Value Assessment, a partnership between Altarum and VBID Health, through a grant from the Pharmaceutical Research and Manufacturers of America (PhRMA). PhRMA extended complete independence to Altarum to select researchers and specific topics. Health Affairs retained review and editing rights. The field of cost-effectiveness analysis (CEA) has grown rapidly but in somewhat lopsided fashion. The number of published cost-per-quality-adjusted life year (QALY) analyses increased from an average of 34 per year from 1990 to 1999, to 484 per year from 2010 to 2014, to 856 per year from 2016 to 2020. However, the analyses have disproportionately focused on prescription drugs, with relatively less attention to health services and procedures. Despite the fact that pharmaceuticals comprise roughly 15 percent of health spending (estimates depend on how the fraction is calculated and range from 10 to 20 percent), 43 percent of CEAs published since 1976 have focused on pharmaceuticals, according to analyses of the Tufts Medical Center’s CEA Registry. While the bulk of health spending comprises services and procedures delivered in hospitals, clinics, and physician offices, only 12 percent of studies have focused on care delivery interventions and 26 percent on medical and surgical procedures. Moreover, the proportion of CEAs devoted to pharmaceuticals has remained steady over time. The Institute for Clinical and Economic Review (ICER)—the nonprofit organization that conducts clinical and economic analyses of health interventions and serves as a kind of de facto national health technology assessment (HTA) agency—has focused mostly on drug therapies. Since 2015, 47 of 54 of ICER’s evaluations have pertained to prescription drugs (two of the 47 evaluations included both drug and non-drug therapies). Non-drug evaluations included assessments of programs to integrate behavioral health into the primary care setting and intensive diet and lifestyle counseling to prevent diabetes. In 2019, ICER announced that it would bolster its efforts to review non-pharmaceutical interventions. However, since then, only two of 18 of ICER’s completed or ongoing assessments have done so: evaluations of digital health technologies and supervised injection facilities in response to the opioid epidemic. In this article, we explore these trends, building on prior studies in the area. We examine reasons for the discrepancies and consider potential action to shore up the evidence base on the cost-effectiveness of health services and procedures.