IRDES Newsletter

Launch of the PSCE Survey

The Ministry of Health's Directorate of Research, Study, Evaluation and Statistics (DREES) and IRDES are launching a new edition of the Survey on Complementary Social Protection offered by employers (PSCE), based on establishments in metropolitan France and in French Overseas Departments (Dom) and their employees, from February 2017. Its objective is to evaluate the generalization of employer provided health insurance implemented in France on 1 January 2016.

 More information (in French)

Reminder

3^rd IRDES Workshop on Applied Health Economics and Policy Evaluation

This third international seminar on health economics and public policy evaluation, organised by IRDES, will take place in Paris 22-23 June 2017.

 Presentation

17^th International Medical Geography Symposium (IMGS 2017)

The International Medical Geography Symposium is the leading international meeting of health and medical geographers. Every two years, the symposium welcomes health geographers and others interested in applying a spatial approach to their research to share findings and form new ideas about the progress of this exciting sub-discipline.
The 17^th IMGS will take place in France in July 2-7, 2017, hosted by University of Angers. The organizing committee, of which IRDES is a member, welcomes all those interested in health geography to attend this conference. The theme of this edition is "Practicing health and medical geography in 2017". Papers and posters presented at the conference will deal with a variety of health issues, including: social perspectives on health; health policy; health care and services; ageing; urban health; rural health; environment and health; GIS approaches; global health; health human resources and health inequities and inequalities.

 Presentation

Disinvestment Strategies for Pharmaceuticals: An International Review

Parkinson B., Sermet C., Clement F., Crausaz S., Godman B., Garner S., Choudhury M., Pearson S.A., Viney R., Lopert R., Elshaug A.G.

Issues in Health Economics (220), July-August 2016

The purpose of this international literature review is to evaluate the partial or full disinvestment policies of some publicly funded or subsidized drugs in five OECD countries (Australia, Canada, France, New Zealand and the United Kingdom). It is based on an international study published in the journal PharmacoEconomics in 2015. Disinvestment can take two forms, passive and active. The first is not linked to direct government intervention: a drug will be withdrawn from the market by the manufacturer for commercial reasons or because of identified safety problems. Active divestment is driven by a political will to improve the efficiency and quality of care by reducing the pressure on pharmaceutical budgets.
While countries rely more heavily on passive disinvestment, they tend to increasingly resort to active disinvestment. Governments are under increasing pressure to disinvest medicines with low therapeutic value in order to provide flexibility for innovative new medicines with recognized efficacy.

High Out-Of-Pocket Payments: Beneficiaries' Profiles and Persistence Over Time

Franc C. (Inserm, Centre de recherche en épidémiologie et santé des populations, Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, Inserm U1018, Villejuif, Irdes) and Pierre A. (Irdes)

Issues in Health Economics (217), April 2016

In France, Out-Of-Pocket payments (OOP) to be paid by the insured after reimbursements by the National Health Insurance (NHI) account for a quarter of health spending on average. However, these costs can be very high for some people and constitute a barrier to access to care, especially when they are repeated over time. From the Health, Health Care and Insurance Survey (Enquête santé et protection sociale, ESPS) matched to healthcare consumption data, we defined profiles of the 10% of individuals who bore the highest burden in OOP in 2010 using a typology. Four profiles are identified based on various care items consumed and then described according to their socio-economic characteristics and health status. The first profile gathers patients primarily treated as outpatients for chronic diseases; the second profile gathers vulnerable individuals hospitalized in a public institution; the third profile mainly relates to employees who have spent on dental care; and the fourth profile gathers non-hospitalized elderly. The results show that individuals belonging to the first profile were the most likely to incur high OOP two years later (in 2012).

The Likely Effects of Employer-Mandated Complementary Health Insurance on Health Coverage in France

Pierre A. (Irdes, CESP Inserm), Jusot F. (Université Paris-Dauphine, PSL Research University, Leda-Legos & Irdes)

Working paper (67bis), January 2017

In France, access to health care greatly depends on having a Complementary Health Insurance coverage (CHI). Thus, the generalisation of CHI became a core factor in the national health strategy created by the government in 2013. The first measure has been to compulsorily extend employer-sponsored CHI to all private sector employees on January 1st, 2016 and improve its portability coverage for unemployed former employees for up to 12 months. Based on data from the 2012 Health, Health Care and Insurance survey, this article provides a simulation of the likely effects of this mandate on CHI coverage and related inequalities in the general population by age, health status, socio-economic characteristics and time and risk preferences. We show that the non-coverage rate that was estimated to be 5% in 2012 will drop to 4% following the generalisation of employer-sponsored CHI and to 3.7% after accounting for portability coverage. With its focus on private sector employees, the policy is likely to do little for populations that would benefit most from additional insurance coverage while expanding coverage for other populations that appear to place little value on CHI. Indeed, the mandate could reduce the relationship between non-coverage and time and risk preferences without eliminating social inequalities as the most vulnerable populations are expected to remain more often without CHI.

Economic Evaluation and Research on Health Services - International Conference Proceedings

Bourgueil Y. (editor)

IRDES Report (565), December 2016, 63 p.
In French

The actors in situation of managing collective health resources must make multiple choices: priorities of actions, prevention programs, allocation of resources, modes of organization and remuneration... The objective of this conference was to present methods and evaluation works to inform public decision and engage actors in organizational change processes. The clear improvement in the fineness of the collected health data as well as the development of methods of analysis transform the way these issues are addressed. Economic evaluation and research on health services provide elements of objectification and analysis that can enrich the debates and reinforce the legitimacy of public decisions often at the heart of contradictory interests. The conference was set up with the perspective of strengthening the evaluation process. It aimed to bring methodological benchmarks and to develop exchanges through international and French experiences. These experiences, both national and regional, will provide different points of view on the development, implementation and use of economic evaluation and research on health services.

The Likely Effects of Employer-Mandated Complementary Health Insurance on Health Coverage in France

Pierre A., Jusot F., Health Policy, Online 5 January 2017, 2017/03, vol 121, Issue 3, 321-328.

Life Course Changes in Smoking by Gender and Education: A Cohort Comparison Across France and the United States

Pampel F.C., Bricard D., Khlat M., Legleye S., Population Research and Policy Review, Online: 09 January 2017, 2017/06, vol 36, Issue 3, 309-330.

Disadvantaged Social Groups and the Cigarette Epidemic: Limits of the Diffusion of Innovations Vision

Khlat M., Pampel F., Bricard D., Legleye S. International Journal of Environmental Research and Public Health, 2016, 13(12), 1230.

Efficiency Measurement for Policy Formation and Evaluation

Charlesworth A., Or Z., Spencelayh E., In "Health System Efficiency: How to Make Measurement matter for Policy and Management", Cylus J., Papanicolas I. and Smith P.C. (Eds), Health Policy Series ; 46, Copenhague : OMS Bureau régional de l'Europe, Chapter 8, 2016, 167-202.

The Effects of Breast Cancer on Individual Labour Market Outcomes: An Evaluation from an Administrative Panel

Barnay T., Ben Halima M.A., Duguet E., Le Clainche C., Regaert C., Paris : Fédération TEPP - CNRS, TEPP working paper, n° 2016-05, 2016/09, 28 p.

... Aurélie Pierre and Carine Franc on the occasion of the publication of Issues in Health Economics (217), April 2016: "High Out-Of-Pocket Payments: Beneficiaries' Profiles and Persistence Over Time"

• What do you mean by "high out-of-pocket payments"? Why studying this question?
• What new information on out-of-pocket payments does the Health, Health Care and Insurance Survey (ESPS) allow you to update?
• Is there a recurrence of certain out-of-pocket payments? For who?

Read the interview