Impact of the 2020 Update of the French Guidelines for Economic Evaluation on the Economic Opinions Issued By the Economic Evaluation and Public Health Committee (CEESP)

OBJECTIVES: Between 2013 and 2022, 199 economic opinions were published by the French Health Authority (HAS/CEESP). In 2011, the HAS published methodological guidelines for economic evaluations, subsequently updated in 2020. The aim of this study was to assess the impact of these new guidelines on the evaluation of the dossiers published.

METHODS: The first step was to classify the reservations according to their dimension (e.g comparator, costs, ...). The second step was to compare the average number of reservations per opinion considering their grading (minor/important/major) and their dimension before and after the publication of the new HAS guidelines. The eligibility decision date was used as a proxy for the date of the submission to the CEESP. A 6-month period after their publication was considered during which the new guidelines had not yet been implemented in dossiers.

RESULTS: Among the opinions reviewed, 151 opinions were assessed based on the 2011 guidelines and 46 on the 2020. The reservations were classified according to around 20 dimensions. On average, before the 2020 guidelines, a total of 8.93 reservations per dossier were issued compared with 8.74 after (4.84 minor vs. 4.28, 3.46 important vs. 4.00 and 0.63 major vs. 0.46). The descriptive analysis of reservations’ dimensions shows trends towards a reduction in the number of reserves for some dimensions – cost data (-24%) - and an increase for others – validation (+99%) - after introduction of new guidelines. Nevertheless, no statistical differences were observed between the two periods of interest, whether on total reservations, or according to their level of severity.

CONCLUSIONS: Regarding some dimensions, updating the guidelines seem to have improved the quality of the dossiers, while in others the HAS' requirements seem to have increased. This study also highlights the dimensions where greater vigilance and rigor are required to obtain a valid economic opinion by the CEESP.