How to value the full cost of medical consultations in France? Results from MOVIE project

In France, the lack of standardized unit cost data is a major barrier to high-quality, easily comparable health economic evaluations. The objective of the MOVIE project was to standardize costing methods and provide accurate estimates of unit costs for French healthcare services. More than 200 million general practitioner (GP) consultations were recorded in France in 2021, at a total billed cost of €10.5 billion - approximately 80% of which was covered by the state health insurance system. In the same year, there were 125 million consultations with specialist physicians, for a total billed cost of €13.9 billion. The baseline per-consultation tariff was €25 for a GP and €31.5-€58.5 for a specialist; however, these figure excluded additional costs and thus were potentially underestimated. The MOVIE project took account of consultation fees, procedure fees, the patient's out-of-pocket payments, and annual physician incentives linked to quality, prevention, and public health activities. In an analysis of a representative 2% sample (the Échantillon du Système National des Données de Santé) of the French National Health Database, the mean GP consultation cost was €39.8 but could amount to as much as €75.1 when additional medical procedures were included. The cost of a consultation with a specialist was €66.1 on average but ranged from €40.2 (for an oncologist) to €104.3 (for a neurologist). Cost variability was driven by the type of consultation, additional procedures, the medical specialty, the practice setting, the patient's age, and the geographic region. By capturing all the relevant cost components, this MOVIE study (i) provides the first comprehensive, validated assessment of medical consultation costs in France (enabling more accurate, more easily comparable economic evaluations) (ii) supports healthcare policy, budget impact analyses, and clinical trial modeling, and (iii) highlights key cost drivers and regional differences.