RESEARCHER-DRIVEN VERSUS POLICY-DRIVEN ECONOMIC APPRAISAL OF HEALTH TECHNOLOGIES - THE CASE OF FRANCE

From the failure of early voluntarist attempts of the 1970's to introd uce formal economic assessment in administrative decision-making for p ublic health policies, to the recent introduction of new regulatory me chanisms to control the diffusion and use of health care technologies, the French experience deeply questions the mechanistic idea that rein forcement of cost-containment policies necessarily means successful op portunities for economic appraisal. The article presents various examp les from the French health care system showing how ambiguities between the management goals of cost-containment and the promotion of economi c appraisal can create barriers for acceptance of any form of economic analysis. But, it also draws some positive lessons about the ways to surpass the traditional opposition between 'researcher-driven' vs 'pol icy-driven' research in the field of health economic assessment throug h institutional innovations and methodological advances.