OBJECTIVES: The Economic and Public Health Assessment Committee (CEESP) was introduced in 2012 as a specialised committee affiliated with the ‘Haute Autorité de Santé’ (HAS) in charge of providing health economic opinions. This research provides a forward-looking analysis of health economic assessment of pharmaceuticals in France and its impact on market access of drugs. It also provides likely directions of the future French HTA organisation and processes. METHODS: We conducted a grey literature search on the HAS website and decision makers’ public presentations and comments. This search was complemented with a meeting with experts in market access and health economics, HTA and public health to discuss the current functioning and the likely future path of health economic assessment in France. The main issues that emerged from the search and the discussion were consolidated and analysed. RESULTS: Major sources of inefficiencies appeared following the introduction of health economic assessment: (1) Duplication of work between the CEESP and the CT; (2) Resolution of divergent opinions between the CEEPS and the CEPS; (3) Confusion and conflicting information with respect to the current regulation and practices; (4) Lack of an ICER threshold. The likely future of health economic assessment of drugs in France will imply the expansion of health economic assessment scope, the implementation of an impactful ICER threshold, the generalisability of coverage with evidence, and eventually the possible merge of the CEESP and the CT. CONCLUSIONS: Major steps in French HTA are expected to occur in the near future. Empowerment of the CEESP (merged or not with the CT) is expected, and it may become the unique or leading committee addressing the HTA of pharmaceuticals in France. However, it is likely that the robust and well-established methodology developed by the CT (SMR, ASMR) to assess comparative efficacy or effectiveness will remain in force.