Abstract

Based on the experience accrued since its launch in 2017, this work summarizes lessons learnt, challenges and opportunities of SNDS in relation to other widely-used administrative databases. The SNDS (Système National des Données de Santé) links national hospital databases, health insurance and other nationwide databases (e.g., administrative death registration). It offers relative completeness in terms of data related to diagnoses, prescriptions reimbursed, acts and procedures performed, as well as cost data in both inpatient and outpatient settings, yet with a few specific gaps. Population coverage (>99%) and time coverage (>10 years) makes it a powerful data system to generate robust real-world evidence, especially when linked to a disease-specific registry. After an overview of the SNDS database content, summary learnings and case-based comparisons with other databases are provided. Perspectives will be shared based also on on-going SNDS developments addressing some of the above-mentioned gaps. This study highlights strengths, weaknesses and opportunities to use SNDS for effective decision-making. Case studies for cost-effectiveness and clinical decision-making demonstrated high relevance and impact of SNDS even for rare and orphan diseases. Sensitivity and specificity of patients identifications and outcomes definitions reach >90% in the cases explored. Examples of algorithms that serve as diagnosis proxies or fill data gaps will be discussed. SNDS is a large, rich and reliable real-world database with unique opportunities for HEOR and clinical research, provided careful implementation and deep understanding of limitations.

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