The public health benefit of medicines: How it has been assessed in France? The principles and results of five years’ experience

Abstract Health technology assessment seeks to inform health policy- and decision-makers by promoting use of current best evidence and by addressing country specific factors, such as local context and values. In France, public health benefit (PHB) is one of the criteria used to inform decisions on t...

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Bibliographic Details
Published in:Health policy (Amsterdam) 2013-10, Vol.112 (3), p.273-284
Main Authors: Maison, Patrick, Zanetti, Laura, Solesse, Anne, Bouvenot, Gilles, Massol, Jacques
Format: Article
Language:English
Subjects:
Assessment
Authority
Benefits
Biological and medical sciences
Cost-Benefit Analysis
Decision Making
Drug and Narcotic Control
Drug policy
Drugs
Drugs policy
Epidemiology
Evidence-Based Practice
France
General aspects
Health administration
Health care
Health economics
Health policy
Health promotion
Health Status Indicators
Health technology assessment
Humans
Internal Medicine
Medical sciences
Medicine
Methodology
Miscellaneous
Pharmaco-epidemiology
Pharmacoepidemiology
Population
Prescription Drugs
Public Health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Technology assessment
Technology Assessment, Biomedical
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Summary:Abstract Health technology assessment seeks to inform health policy- and decision-makers by promoting use of current best evidence and by addressing country specific factors, such as local context and values. In France, public health benefit (PHB) is one of the criteria used to inform decisions on the reimbursement of medicines. This article describes the methodological framework and the results after five years of assessment of PHB, by the French National Authority for Health. The semi-quantitative method used includes three dimensions that are: (1) the ability of a drug to improve the population's health status, (2) the drug's adequacy to cover public health needs, and; (3) the impact of the drug on the healthcare system. From 2005 to 2010, the PHB of 530 drugs was estimated, and 72% were assessed as having no PHB. The PHB was “low” for 88% of drugs expected to have a PHB, “medium” for 10%, and was considered to be “high” in only one case. The results of this experience show that it is feasible to assess the public health impact of drugs. But the high level of uncertainties at the time of a drug's first appraisal limits the assessment, which obviously has to be completed by reappraisal with post-marketing studies.
ISSN:0168-8510
1872-6054
DOI:10.1016/j.healthpol.2013.04.007