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Bourg-la-Reine, France

The objective of this study was to estimate the investment of pharmaceutical industry in hospital clinical research in France for 2010. The method consisted in combining data extracted from various sources about volumes of patients and unit costs per patient according to phase (I, II and II) and therapeutic domains. The numbers of French patients enrolled were estimated through an extraction of the National Institute of Health (NIH) database. Unit costs per patient were estimated from a sample of 54 clinical studies covering the most frequent combinations of phases and therapeutic domains and documented independently by 5 international companies. We identified 1â 178 clinical studies ongoing in 2010, having included a total of about 73â 000 French patients. Among these studies, 40.3% and 12.8% concerned Onco-Haematology and Rare Diseases respectively. The total annual investment from industry was estimated at 488 million euros, comprising 83.6 M€ of medical honoraria (17%), 73 M€ of hospital extra cost (15%), 99 M€ of drug provision (20%) and 232 M€ of internal cost for french affiliates (48%). © 2012 Société Française de Pharmacologie et de Thérapeutique. Source


Economics was only recently considered as a dimension of health technology assessment in France. Yet there are always limits in resources that we collectively agree to devote to health. A comparative "economic" appraisal is therefore needed to guide health choices and contribute to price regulation. Methodologies are based on the determination of incremental cost-effectiveness ratios compared with a reference. The interpretation of these ratios is never isolated from the context of the decision. Health economic evaluation is not involved in healthcare rationing, but it contributes to the rationality of decisions in the interest of the overall population. © 2014 médecine/sciences - Inserm. Source


Demarteau N.,Glaxosmithkline | Detournay B.,Glaxosmithkline | Tehard B.,Cemka Eval | El Hasnaoui A.,Glaxosmithkline | Standaert B.,Glaxosmithkline
International Journal of Public Health | Year: 2011

Objective: This study aimed at evaluating the cost-effectiveness of human papillomavirus virus (HPV) vaccination in France, using a generally applicable succinct cohort model. Methods: A lifetime Markov cohort model, adapted to the French setting, simulate the natural history of oncogenic HPV infection towards cervical cancer (CC). Additional modules account for the effects of screening and vaccination. The girls' cohort is vaccinated at age 12 and follows current screening. Costs and outcomes (discounted at 3 and 1.5%, respectively) were compared with a cohort receiving screening alone. Results: The model results agreed well with real-life data. Vaccination in addition to screening would substantially reduce the incidence of and mortality from CC, compared with screening alone, at an estimated cost-effectiveness of 9,706 per quality-adjusted-life-year. Sensitivity analysis showed that the discount rate and the parameters related to the disease history have the largest impact on the results. Conclusion: This succinct cohort model indicated that HPV vaccination would be a cost-effective policy option in France. It uses readily available data and should be generally applicable to the evaluation of HPV vaccination in a variety of countries and settings. © 2010 Swiss School of Public Health. Source


Detournay B.,Cemka Eval
Archives of Cardiovascular Diseases Supplements | Year: 2016

Vitamin K antagonists (VKAs) were until recently the main oral anticoagulants pharmaceutical class. Their large use can result in significant costs to the health system in France that cannot be summarized in the direct price of VKAs but might also take into account the costs associated with biological monitoring (INR) and the accidents due to over- (hemorrhage) or under-dosage (ischemic complications) associated with these treatments.On the basis of data from the various systems of health insurance in France in 2013, the expenses amounts reimbursed for VKA reached about €40 million for more than 12 million of boxes. About 20 million INR measures were prescribed the same year, with a cost of €156 million reimbursed that year. The number of INR seems in line with the recommendations (1.6 measures per month per patient).The annual cost of hospitalizations for major bleeding related to the VKA would be meanwhile at least €90 million for 40 000 hospitalizations per year. The cost of INR monitoring by health professionals is more difficult to estimate as well as the costs associated with complications resulting from VKA underdosage or minor complications of VKA over-dosage. On the basis of these estimates, the direct costs reimbursed by health insurance for VKA treatment probably exceed €300 million per year. The societal costs (including indirect costs) and the burden are still higher. © 2016 Elsevier Ltd. Source


Charbonnel B.,Nantes University Hospital Center | Penfornis A.,Besancon University Hospital Center | Varroud-Vial M.,Service de Diabetologie | Kusnik-Joinville O.,Cemka Eval | Detournay B.,Cemka Eval
Diabetes and Metabolism | Year: 2012

Aims: To describe insulin therapy in patients with diabetes, to determine treatment costs and to compare costs among treatment regimens. Methods: This observational study was performed by 734 French pharmacists. Adult patients filling an insulin prescription were invited to participate. Participants provided information on their diabetes history and management. Levels of intensification of insulin therapy were determined by the number of injections in type 1 diabetes mellitus (T1DM) patients, and by the different schemes used in type 2 (T2DM) patients, such as basal/intermediate-acting insulin only, and regimens using both basal and rapid-acting insulin. Costs were evaluated according to official medication costs, nurse visits and glucose monitoring kits. Results: A total of 361 patients with T1DM and 1902 with T2DM were enrolled in the survey. Patients with T1DM more frequently took 1-2. injections per day (46.3% of patients) and used single-dose basal insulin together with ≥ 1 dose of rapid insulin (43.8%). Patients with T2DM used multiple treatment regimens, with 58 different combinations documented. Most took basal/intermediate insulin only (42.5%) or combinations of basal/intermediate and rapid insulins (52.7%). Mean cost of insulin therapy was € 27.4/week for T1DM and € 45.4/week for T2DM. In T1DM, insulin was the biggest cost component and increased with the number of injections/day. In T2DM, nurse visits were the most important cost contributors irrespective of treatment regimen. Overall, the cost of insulin therapy increased with the complexity of the insulin schemes. Conclusion: Considerable heterogeneity is found in insulin treatment regimens used in everyday diabetes care. Payers should consider the full costs associated with the use of insulin rather than the cost of insulin alone. Treatment algorithms to harmonize insulin therapy should help to improve care, while encouraging patients to self-inject insulin should help to reduce costs. © 2011 Elsevier Masson SAS. Source

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