Presentation (CTI)

OBJECTIVES: Economic evaluation was integrated into health technology assessment (HTA) in France since 2013. However, France still lacks an explicit reference value to contextualize incremental cost-effectiveness ratios (ICERs). Previous research proposed French estimates of the willingness-to-pay for a quality-adjusted life-year (WTP-Q), between 27,847€ and 112,586€, derived from the current 3 M€ French Value of a Statistical Life (VSL). Recent OECD work updated VSL estimates using a substantially expanded evidence base including both stated- and revealed-preference studies. This study aimed to update French WTP-Q estimates using these new OECD VSL values and assess implications for HTA decision-making.
METHODS: We applied a previously published framework linking VSL to WTP-Q through lifetime health utility and risk-aversion functions. French demographic and life-expectancy data were combined with three EQ-5D-3L and 5L French utility datasets to estimate population-weighted WTP-Q values. Updated VSL assumptions were tested. Scenario analyses explored different levels of risk aversion and utility specifications. Population weighting was applied to ensure consistency with equity principles underlying public healthcare decision-making
RESULTS: Using updated OECD VSL estimates for France (€5.5-5.7 million), WTP-Q estimates ranged from €176,000 to €214,000 under risk neutrality and from €47,000 to €54,000 under maximum risk aversion, depending on the utility dataset used. Estimates based on EQ-5D-5L utilities were consistently lower than those derived from alternative utility sets. Risk aversion reflects the extent to which payers are reluctant to invest in health technologies when future health benefits are uncertain
CONCLUSIONS: Reference values remain important for interpreting CEESP economic evaluations and supporting price negotiations with the French Pricing Committee (CEPS). Updating French WTP-Q estimates using the latest OECD evidence suggests that societal valuation of health gains may be higher than previously estimated. These findings provide updated evidence to inform discussions on value assessment, pricing and access to health innovation in France