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Master Thesis

L’évaluation du médicament : évaluation comparative de la HAS (France) et du NICE (Royaume-Uni), cas des antinéoplasiques entre 2015 et 2019

Abstract : Objectives: Facing increasing financial pressures on health care budgets, governments have taken measures to regulate health expenditures. The evaluation of any medicine seeking reimbursement is one of them. British NICE and French HAS are two of the most influential evaluation agencies in Europe. Their decisions are impacting access to health care, and specifically for oncology drugs where price levels are high. This work compares evaluation approaches and reimbursement decisions of antineoplastics by the two agencies. Methods: First of all, the principles of medico-economic evaluation are stated. Used as a key criterion by NICE, it is essential to understand the decisions of the British agency. Secondly, evaluation approaches of NICE and HAS are presented, emphasising the discrepancies. Finally, the reimbursement decisions of antineoplastics between 2015 and 2019 by the two agencies are compared. Results: The use of medico-economic evaluation is probably the most prominent point of contrast between NICE and HAS. Other aspects, like reimbursement rates, the implication of external groups, or the temporary funding of oncology drugs also differentiate the two approaches. 32% of antineoplastic reimbursement decisions are similar between NICE and HAS, 53% of indications are not reimbursed for the same population, and 15% are reimbursed in one country but the other. Different statistical interpretations and the use of medico-economic evaluation in the decision process are the main reasons of discrepancies. Discussion: Divergences between evaluation approaches of NICE and HAS lead to different reimbursement decisions of antineoplastics, directly impacting access to health care. Although some discrepancies could reduce the coming years (HAS is willing to extend the use of medico-economic evaluation, for instance), they remain strong and highlight the different political, economic and philosophical conceptions between the two countries.
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Master Thesis
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Submitted on : Thursday, December 10, 2020 - 9:52:00 AM
Last modification on : Saturday, December 12, 2020 - 3:26:08 AM
Long-term archiving on: : Thursday, March 11, 2021 - 6:49:30 PM


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  • HAL Id : dumas-03050100, version 1


Jean-Baptiste Trouiller. L’évaluation du médicament : évaluation comparative de la HAS (France) et du NICE (Royaume-Uni), cas des antinéoplasiques entre 2015 et 2019. Sciences pharmaceutiques. 2020. ⟨dumas-03050100⟩



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