Serie : Journal de gestion et d'économie de la santé : évaluation des pratiques et des organisations de santé. Vol 40-4
Paru le 22/02/2023 | Broché
Professionnels
Call for papers - Special Issue
Journal de Gestion et d'Économie de la Santé
10 years of the CEEP's Opinions : Achievements and Perspectives
Since 2013, the economic evaluation of innovative health technologies has become mandatory, in the market access process in France. The cost-effectiveness criterion has thus been added to the two existing indicators SMR and ASMR used by the French National Health Authority (HAS), to determine the value of an innovation and support pricing decisions.
On the occasion of the 10th anniversary of the CEESP's Efficiency Opinions, the JGES wants to devote a special issue to the regulatory economic evaluation mission of the HAS. The objective is to draw up a progress report but also to outline the perspectives in which this mission could be deployed in the years to come.
The expected contributions for this special issue should make it possible to represent the viewpoints of the various stakeholders : regulator, patient, industry and citizen, using approaches that may be qualitative or quantitative.
In a backward-looking perspective, one may ask what outcomes were achieved by the additional information provided by Efficiency Opinions, whether on the supply side in terms of regulation, or on the demand side in terms of access to innovations. For example, how did the so-called 'Reserve Majeure' translate into coverage and pricing ? How is France doing in terms of access time to innovations ?
The review and the retrospective analysis can also be made with regard to the various methodological adaptations that have taken place over the last 10 years (relationship between BIA and efficiency, uncertainty treatment, etc.) or in comparison with the practices of other countries, particularly European countries.
In a forward-looking perspective, one of the objectives of this special issue is to identify the challenges and priority areas for this evaluation mission.
Firstly, in methodological terms, what methodological adaptations can be anticipated given the current landscape of innovations ? Does the definition adopted for the perspective and therefore for the scope of the costs and benefits considered, accommodate the challenges of health innovations, whether they are organisational, medical or in terms of equity ? To what extent is it both possible and desirable to include the cost of informal care ? What are the difficulties associated with using real-life data ?
Secondly, in public decision terms : recent empirical studies aimed at determining cost-effectiveness thresholds have fuelled the debate on the price of innovative drugs. What can be said about the levels of the Incremental Cost Effectiveness Ratio at which innovative pharmaceuticals are funded in France, in a context where the level of prices threatens the sustainability of socialized financing and appears to be disconnected from firms' R&D expenditures ? Should the definition of a Cost Effectiveness threshold or a range of thresholds be on the agenda ?
Finally, in terms of deliberative democracy, how can patients' and citizens' preferences enrich the results of the efficiency assessment beyond the participation of their representatives in the CEESP ? Is it possible to structure differently the qualitative opinions of patient associations that are solicited in the Efficiency Opinions to increase their weight ? How can the Efficiency Opinions be used to promote a collective debate on priorities in the allocation of health resources and the opportunity cost of public spending ?
