Objectives

• Identify and categorise technologies offering prospects for efficiency gains outside incremental innovations (higher quality/higher costs)

• Clarify under which conditions decremental cost-effectiveness is acceptable for collective health gains

• Develop a tool-box for use at a local level for HTA projects to maximise those health gains

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Methodology

• Systematic search of clinical trials registries and published literature to identify decrementally cost-effective programmes, as for example non-drug interventions or non-inferiority trials

• Conduct a systematic enquiry into the willingness of stakeholders (namely patients, professionals, decision makers, tax payers) to accept a decremental efficacy

• A toolbox and guidance for HTA agencies to go beyond cost-effective comparators in their assessments and recommendations

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Outcomes

• The algorithm used to identify the decrementally cost effective programmes will be published as well as a state of art analysis in Europe of candidate technologies
   

• An analysis of the obstacles and potential drivers for acceptance of decremental efficacy using a political economy approach of stakeholders’ perspectives
   

• The toolbox will provide specific methodological and policy guidance concerning the evaluation and implementation of candidate technologies 

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Outputs

• November 2019 – Budget impact analysis of triple therapy after failure of methotrexate for the treatment of rheumatoid arthritis in France – ISPOR Europe [weblink]
   

• November 2019 -  Annual cost of patients undergoing a total knee replacement in France – ISPOR Europe [weblink]
   

• Toolbox on candidate cost-effective technologies for HTA producers and users [PDF]
   

• Systematic review of decrementally cost-effective interventions [PDF]

Leads

Paris School of Economics – Hospinnomics

 

Assistance Publique-Hôpitaux de Paris

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Principal Investigators

Lise Rochaix

Isabelle Durand-Zaleski