Choices in Methods for Economic Evaluation

This guide presents the principles and methods used by HAS (the French National Health Authority) to carry out its mission of providing economic evaluations of health interventions. In this specific context, economic evaluation allows health interventions to be compared on the basis of their health effects and costs.

Following examples in other areas of evaluation covered by HAS, this work on formalising reference case analysis strives to guarantee rigour, transparency and methodological homogeneity in health economic evaluations. It also aims to ensure that the results of such evaluations are adopted by providing healthcare professionals and institutional decision-makers with the keys to understanding the approaches adopted.

This document provides guidance on the selection and analysis of scientific literature in the systematic reviews made by HAS and defines the basic methodology used in the economic evaluations which it undertakes, initiates or about which it is asked to give expert opinion.

In the document, the expression “reference case analysis” is used to refer to an evaluation made using the methodology chosen by HAS. Such reference case analysis meets the scientific requirements applied by HAS, while leaving room for adaption to the specific features of a particular evaluation or to operational difficulties. That is why the reference case analysis adopted by HAS distinguishes two levels of recommendations: certain guidelines are “required” systematically in the evaluation, whereas others are “preferred” but may not be followed, where this choice is clearly justified. HAS is in fact aware that such economic evaluation in France is still in the development phase and that difficulties such as the lack of available data limit the strict application of these methodological principles.