Presentation (CTI)

OBJECTIVES: Health products and interventions represent a major challenge in terms of access to care, budgetary sustainability, and, with growing awareness, environmental impact. In this context, health economic evaluations are increasingly used to inform decision-making, and recent studies have begun to explore ways to incorporate environmental considerations. The objective of this study was to identify methodological approaches and practical applications for integrating environmental impact into health economic evaluations.
METHODS: A literature review was conducted in PubMed to identify publications addressing the valuation of environmental impact in health economic evaluations. The selection process was carried out in two steps: an initial screening based on titles and abstracts, followed by a full-text review.
RESULTS: Out of 278 references initially identified, 10 articles were included. 5 articles described methodological approaches for integrating environmental impact into health economic evaluations. Three approaches were identified : (1) cost-utility analysis (CUA) incorporated environmental consequences by translating their effects into utility-based health outcomes, (2) cost-benefit analysis (CBA) focused on assigning a monetary value to environmental externalities, and (3) multi-criteria decision analysis (MCDA) integrated environmental impact as a criterion, alongside clinical and economic factors. The remaining 5 articles presented practical applications illustrating how these approaches have been used in practice. 2 articles used a CBA with the social cost of carbon (SCC), 1 applied a CUA using disability-adjusted life years (DALYs), 1 combined DALYs and SCC as dual approaches to capture the environmental impact and 1 used incremental carbon footprint effectiveness and cost ratios (ICFER/ICFCR). These practical applications covered chronic respiratory diseases (n=2), obesity (n=1), end-stage renal disease (n=1), and cancer (n=1).
CONCLUSIONS: Recent methodological advances highlight growing interest in environmental integration within health economic evaluations, but the lack of consensus on a standardized approach and the limited number of applied models underline the need for further research.