Level of ICER of Health Economic Assessment in France in 2024
Author(s)
Bertrand Tehard, MSc, PhD, Cléa SAMBUC, PhD, Julie Chevalier, MASc, PhD.
Vyoo Agency, Paris, France.
Vyoo Agency, Paris, France.
OBJECTIVES: In France, the main objective of the health economic assessment is to inform the price negotiation, through the incremental cost-effectiveness ratio (ICER). The methodological validity of the ICER is appraised by the Economic and Public Health Assessment Commission (CEESP). The framework agreement signed between the pharmaceutical industry and the French Pricing Committee (CEPS) stipulates that economic evaluation can only be considered in negotiations in the absence of a major methodological reservation or major uncertainty.
METHODS: Using the Vyoo Agency database, which collects all the opinions published by the CEESP since 2014, validated health economics assessments published by CEESP between January 1st and December 31st, 2024, were reviewed to analyze the levels of ICERs.
RESULTS: In 2024, the CEESP validated 8 health economic assessments on 19 evaluations submitted. These opinions concern four therapeutic areas, with two conclusions of dominance and an average ICER of €129,878 per QALY, a decrease of 66% compared to 2023 €382,627 per QALY). The 2024 ICERs varied weakly: 1 ICER is below €50,000 per QALY, 2 between €50,000 and €150,000, 1 between €150,000 and €250,000, and 2 treatments are dominant. For cancer treatments, ICERs varied between dominance and €237,255 per QALY (highest validated ICER in 2024). Dominant treatments were Vaxneuvance for pneumococcus meningitis and nivolumab in early NSCLC.
CONCLUSIONS: These levels of ICER are high compared to those accepted abroad, notably the UK. This is partly explained by CEESP’s methodological requirements on one side and the fact that the cost-effectiveness analysis is conducted on the treatment price before negotiations with the French Pricing Committee. The CEESP’s recommendations for exploring and controlling uncertainty leads to the selection of conservative assumptions to prevent any risk of underestimating ICER. Another observation is that ICER varied widely. The inclusion of uncertainty in the main analysis generates some of this variability.
METHODS: Using the Vyoo Agency database, which collects all the opinions published by the CEESP since 2014, validated health economics assessments published by CEESP between January 1st and December 31st, 2024, were reviewed to analyze the levels of ICERs.
RESULTS: In 2024, the CEESP validated 8 health economic assessments on 19 evaluations submitted. These opinions concern four therapeutic areas, with two conclusions of dominance and an average ICER of €129,878 per QALY, a decrease of 66% compared to 2023 €382,627 per QALY). The 2024 ICERs varied weakly: 1 ICER is below €50,000 per QALY, 2 between €50,000 and €150,000, 1 between €150,000 and €250,000, and 2 treatments are dominant. For cancer treatments, ICERs varied between dominance and €237,255 per QALY (highest validated ICER in 2024). Dominant treatments were Vaxneuvance for pneumococcus meningitis and nivolumab in early NSCLC.
CONCLUSIONS: These levels of ICER are high compared to those accepted abroad, notably the UK. This is partly explained by CEESP’s methodological requirements on one side and the fact that the cost-effectiveness analysis is conducted on the treatment price before negotiations with the French Pricing Committee. The CEESP’s recommendations for exploring and controlling uncertainty leads to the selection of conservative assumptions to prevent any risk of underestimating ICER. Another observation is that ICER varied widely. The inclusion of uncertainty in the main analysis generates some of this variability.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HTA219
Topic
Economic Evaluation, Health Technology Assessment
Topic Subcategory
Value Frameworks & Dossier Format
Disease
No Additional Disease & Conditions/Specialized Treatment Areas