OBJECTIVES: In France, the main objective of economic evaluation of health technologies is to estimate an incremental cost-effectiveness ratio (ICER). The CEESP (Economic & Public Health Assessment Commission) provides an economic opinion on its validity. The ICER is considered validated in the absence of a major reservation or major uncertainty. A validated ICER is expected to provide economically relevant information for the price negotiation with CEPS (French Pricing Committee).

METHODS: Using Vyoo Agency efficiency database, all available validated Health Economic appraised by CEESP between January 1 and until December 31, 2022, were reviewed to analyze the levels of ICERs.

RESULTS: In 2022, the CEESP validated the results of 13 health economic assessments. Eleven of these opinions concern cancer treatments, 1 onco-hematology and 1 hematology, with an average ICER of €153,392/QALY. The levels of ICER vary widely: 2 ICERs are below €50,000/QALY, 5 between €50,000 and €150,00/QALY, 3 between €150,000 and €250,000 and 3 above €250,000/QALY. In cancer treatments, ICERs range vary between €33,110/QALY and €250,086/QALY. The highest ICER is for Onco-Hematology indication with 295 406 €. In hematology, one opinion reports an ICER of 66 335€/QALY in a sub-indication and a dominant result in another.

CONCLUSIONS: These levels of ICER are high compared to those accepted abroad, notably the UK. This is partly explained by CEESP’s methodological requirements. The CEESP’s commitment to explore and control uncertainty leads to select conservative hypotheses to prevent any risk of underestimating the ICER. This trend does not fit well with the threshold of dominance, currently the only threshold considered by the CEPS to influence and speed up the price negotiations. Defining a reference value for qualifying ICERs appears to be necessary to provide concrete information that can be used in price negotiations between manufacturers and the CEPS.