The 2012 law for financing the social security system (LFSS) introduced the criterion of efficiency in setting the prices of innovative health products. The implementation of this provision by the High Authority for Health (HAS) and the Economic Committee for Health Products (CEPS [Comité Économique des Produits de Santé]) highlights the issues of economic evaluation in order to make health decisions. To document the efficiency criterion, HAS favours using cost-results analysis, which compares the health gain to its marginal cost. The interpretation of quantitative results from these analyses is confronted with the need to collectively define the amount that the community is willing to spend to get an extra unit of health. Four methods of estimating the reference value are identified in the literature. They are all used to estimate an acceptability indicator, but suffer from limitations that call for further academic research on this topic. However, assessments made by industrialists, the critical analysis made by the HAS, and the opinions on efficiency provided by the Economic and Public Health Evaluation Commission (CEESP) [Commission d’évaluation économique et de santé publique], illuminate the relationship between the cost of a health product and the health results it generates. The recent development of efficiency notices in France seems to play an effective role in negotiating prices, although its use in the decision-making process remains largely confidential. Like the practices in foreign countries, the criterion of efficiency in health decisions must find its place in a deliberative and transparent arbitration among other criteria of judgement, identified as relevant in defining the social value of a health product.
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