Abstract

To decide if a new drug or a new therapy has to be reimbursed, we usually perform a cost-utility analysis to express the cost of gained life year in good health (QALY). Through this method, we can express a relative level of efficiency (only the countries where a threshold is used can declare a new drug or a new therapy ‘not efficient’ in absolute terms). In Belgium, we are developing a different approach based on the social preferences. We have determined the weight of specific criteria which characterized the societal need, the therapeutic need and the added-value of new therapies. By using these results we are able to classify health products or medical needs. A ‘little revolution’ in the world of Health economics. Nevertheless, this approach has to be used cautiously because, if we avoid the critics of the utilitarian approach of the cost-utility analysis, we are confronted with the versatile character of the opinions, the social preferences. Last but not least, neither the cost-utility analysis, neither the approach based on social preferences avoid the problem of the prices which will remain a huge ethical challenge.

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