OBJECTIVES: Since 2013, an economic evaluation is required in France for certain healthcare products/technologies. The economic opinion development process includes a contradictory phase where manufacturers can submit written observations on the draft opinion and/or participate in a hearing with the Commission for Economic and Public Health Evaluation (CEESP). This research aimed to assess how contradictory phases can potentially lead to modifications in CEESP conclusions over the last 3 years.

METHODS: Based on the most complete published meeting minutes of the CEESP, a double extraction was conducted to isolate the hearings and written observations for each product evaluated between January 2021 and March 2024. The manufacturer’s claims, the CEESP’s conclusions post-contradictory phase, and the impact (positive, negative, or neutral) were collected. To complete the analysis, a specific focus on hearings since 2014 was conducted additionally.

RESULTS: A total of 62 meeting minutes were reviewed.

From these, 11 cases of hearings were isolated: 2 led to changes in the initially pronounced results and had a positive impact, including the reclassification of important reservations into minor and the addition of results. One case stands out for the addition of an important reservation.

27 cases of written observations were reported, resulting in 9 cases where the outcome was modified with a positive impact on the result initially pronounced. This included the reclassification of a major reservation into important reservation, important reservations into minor reservations, and the deletion of a reservation.

Attending hearings results in a positive impact on the outcome in 18% of cases, while for written observations, it rises to 33%.

CONCLUSIONS: Contradictory phases are of significant interest for manufacturers, although changing the level of validity of the opinion is an exceptional case. Nevertheless, these phases add extra time for exchanges between the Commission and manufacturers, improving alignment between them and frequently leading to reformulations.