Care pathway, towards the establishment of tailored funding: Reasons and criteria for success.

Care pathways are often at the forefront of political thinking about health care practices in France without ever finding a durable means for their extension. Closely linked to funding of healthcare system, they have, once again, been the object of so many economical discussions in 2017, as part of a more optimistic climate of governance which is therefore more open to change. Our changing system, the development and increasingly chronic nature of diseases, the scale of technological breakthroughs, these are all factors driving this topic forward.

What is the budget impact of a new treatment or new health technology arriving on the market?

In France, market access for innovative drugs (level I, II & III improvement of medical service rendered having significant impact on health insurance expenditure) involves medico-economic evaluation. In addition to cost-effectiveness analysis (CEA), budget impact analysis (BIA) can be performed, especially since the sustainability of the health insurance system has become a growing concern for all stakeholders. The members of the Giens 2016 round table discussed the contribution of BIA based on a review of the literature on distribution models, the participants' experiences including experience related to the modalities of hospital assessments, and examples from other countries.

Outcomes and general health-related quality of life among patients medically treated in general daily practice for lower urinary tract symptoms due to benign prostatic hyperplasia.

Objective: This study's aim was to describe and evaluate outcomes of medical strategies used for lower urinary tract symptoms (LUTS) treatment in general practice and to assess impact of LUTS on patients' general health-related quality of life (HRQoL).

Methods: This cross-sectional observational study was conducted by French general practitioners. Eligible patients were males aged ≥50 years, diagnosed for at least one year and currently treated for LUTS due to benign prostatic hyperplasia (BPH).

Heparin-induced thrombocytopenia: an estimate of the average cost in the hospital setting in France.

Heparin-induced thrombocytopenia is a severe drug adverse effect with possible dramatic consequences. The risk is 0.1% to 5%.

Economic evaluation of a combined DTPa, hepatitis B, polio, Hib vaccine. Potential impact of the introduction of Infanrix-Hexa in the French childhood immunisation schedule.

A new hexavalent combination vaccine, Infanrix-HEXA, including a recombinant hepatitis B vaccine in addition to the vaccines for diphtheria, tetanus, pertussis, poliomyelitis, and Haemophilus influenzae type B, has recently become available in France. The objectives of this study were to: (1) estimate the break-even price of Infanrix-Hexa for the National Sickness Fund; (2) evaluate its potential impact on vaccine coverage for hepatitis B and the corresponding budget impact. The public price of Infanrix-HEXA associated with a break-even point would be 53.