Analyse critique de méthodes d'évaluation économique des actions de santé : l'exemple du dépistage prénatal de la trisomie 21

Abstract

Valérie Séror: A critical analysis of methods of economie evaluation of public health intervention: the example of prenatal screening for Down's syndrome. Methodologies stemed from public economies field are more and more frequently used in order to assess health care public policies. While these evaluation studies are working towards the development of standardized methodologies, theorical and empirical difficulties still remain. This paper considers economie concepts underlying the measure of costs and health consequences as effectiveness and benefit. After a brief account of the different tools at the economiste disposal, emphasis will be put on identification and measurement of allocated resources in the way of comparability of economie evaluations. A special attention will be given to consequences identification and assessment, according to cost effectiveness and cost-benefit analysis principles. The latter will be analyzed according to social rentability perspectives and willingness-to-pay as an integrative tool of individual preferences. Contributions resulting of the use of economie evaluation methodologies in health care, as well as theorical and empirical difficulties will be discussed in the special case of Down's syndrome prevention, a particularly illustrative example.