Essays on economic evaluation of efficiency in health care interventions

Résumé

The objective of this work is the evaluation of the impact of new direct acting antivirals for Hepatitis C as a case of disruptive healthcare innovation that challenged healthcare systems. Two systematic reviews address cost-utility analyses of new therapies and productivity costs of Hepatitis C. Then we present an assessment of clinical guidelines update at a European level from 2016 to 2018 and the method addresses methodological issues identified as lacking in previous works. Specifically, the Markov model included productivity cost measurement and real drug acquisition costs. The results confirm that European update on Hepatitis C treatment recommendations was efficient as it yielded health gains and savings on the cost side. Economic evaluation can be useful not only to assess healthcare innovations, but also as an efficiency test of clinical decisions.