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Background: Currently, few studies investigated the economic burden of atopic dermatitis (AD) in adult patients and specifically the estimation of out‐of‐pocket costs. Patients with skin disorders primarily use comfort care to ease dryness, itch or pain, and the costs of comfort care are not subject to any reimbursement from mandatory or complementary insurance. Objective: The purpose of this study was to measure the medical and non‐medical expenses paid by the patient. Methods: Eczema Cohort Longitudinal Adults was a non‐interventional study that aimed to assess the burden of AD in terms of quality of life and financial consequences. A self‐assessment questionnaire was distributed to adult patients who were cared in four French hospitals. Patients were asked to list the resources consumed for the treatment of AD during the last 12 months and to estimate the corresponding amount of money they had to pay out of their own pockets. The severity of AD was subjected to a stratification based on the PO‐SCORAD score. Results: A total of 1024 patients answered the questionnaire: 31.9% with severe AD, 40.4% with moderate AD and 27.6% with mild AD. The mean annual out‐of‐pocket cost was €462.1 for severe AD and €247.4 for moderate AD. Emollients were the most commonly used product: 74.4% for an average out‐of‐pocket cost of €151.4. The out‐of‐pocket costs increased significantly with the severity: 27% of patients with severe AD declared having bought specially textured clothes, while 19% of patients with moderate AD reported the same. The corresponding mean out‐of‐pocket costs were €162 and €91, respectively. Conclusion: The amount of out‐of‐pocket costs for patients with AD for essential medical and non‐medical expenses is relatively high, compared to the average out‐of‐pocket cost for French households. Integration of these essential resources into the list of reimbursed products and services appears necessary for a better coverage of AD. Linked Commentary: A. Zink. J Eur Acad Dermatol Venereol 2019; 33: 1817. https://doi.org/10.1111/jdv.15856. [ABSTRACT FROM AUTHOR]

Our objective was to review the linguistic validation of the 20 item-ChronIc Venous dIsease quality-of-life Questionnaire (CIVIQ-20) in the countries that have used it since its publication in 1996. Seventeen linguistic versions of CIVIQ-20 were validated using forward/backward methodology in patients presenting with chronic venous disease, stages C0s to C4 of the CEAP (clinical, aetiological, anatomical and pathological) classification (patients with venous ulcers were excluded). Most obstacles in the cross-cultural validation of CIVIQ-20 related to content and semantic equivalence. Confirmation of cultural relevance by experts with the native language as their mother tongue and the use of forward/backward translation methodology partly resolved these difficulties. CIVIQ-20 is valid for the assessment of treatment effects in multinational studies. [ABSTRACT FROM AUTHOR]

Background: The factorial instability of the CIVIQ-20 social dimension in different populations has necessitated the development of a new stable questionnaire to interpret results from international studies. Objective: Construction of a stable and psychometrically validated questionnaire from CIVIQ-20. Methods and major findings: A prospective, international study was used to construct a stable CIVIQ scale and to validate its psychometric properties. An iterative process was implemented to eliminate the more unstable items (six), and the social and physical dimensions were combined. The resulting instrument comprised 14 items, split into three dimensions (pain, physical, and psychological), and was named CIVIQ-14. The stability of the CIVIQ-14 factorial structure was confirmed in Polish, Czech, Spanish, and French populations using principal component analysis and multitrait/multimethod analysis. Psychometric assessment demonstrated that CIVIQ-14 was reliable (intra-class coefficient >0.8; weighted kappa >0.8), valid (correlation coefficients between dimension scores and clinical severity scores between 0.3 and 0.6), and sensitive (effect sizes >0.6 for psychological dimension; >0.8 for the other dimensions). Conclusion: CIVIQ-14 is a reliable, valid, and sensitive instrument applicable to international studies of patients with chronic venous disease. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the budget impact implied by the introduction of rituximab after failure of one or more anti-TNFalpha therapies in the perspective of the French health care system.Methods: A Markov model reproduced the course, over 4years, of patients treated either by infliximab, etanercept, adalimumab or RTX, after failure of one or more anti-TNFalpha therapies, in a multicentric study. A sensitivity analysis was developed to account for patients in 3rd and subsequent lines of treatment who are expected to consume more healthcare resources.Results: When RTX is not used, total annual medical cost is euro16,555 per patient, euro13,206 of which are dedicated to drug acquisition. When RTX is the only treatment in use, these costs decrease respectively to euro11,444 and euro7469. Total savings per patient and per year is euro5000. Over 4 years, total savings for the targeted population reach euro118M. In the sensitivity analysis, the difference between H2 and H2-coeff 2 (20%) reaches euro5,400,000 in total direct costs during the first year of simulation. This difference decreases along the period, to reach euro2,400,000 the fourth year of simulation, and is due to the fact that rituximab acquisition costs are independent from the treatment line.Conclusion: If TNFalpha inhibitors were the only treatment available, the annual global cost of treatment would be euro16,555 per patient versus euro11,444 for patients treated exclusively with rituximab. RTX is expected to produce important savings (-31%) if used after failure of one or more TNFalpha therapies. This is mainly due to its lower drug acquisition cost. These savings could increase with the development of rituximab in earlier stages of treatment. [ABSTRACT FROM AUTHOR]

The aim of the study is to evaluate the cost-utility ratio of microstructure networks (MSN) in patients undergoing opioid substitution therapy management. A qualitative first stage identified the criteria involved in the opioid management dependence, according to both physicians and patients for MSN or conventional follow-up. On the patient side, preferences differ little from those of doctors, although "access to an experienced doctor" is the most valued criterion and "control of consumption" is given as much importance as changing lives. [Extracted from the article]

Summary: Quality of life measurement shows interesting parameters in chronic lymphedema, related to the illness consequences and therapeutic strains. The ULL27 specific scale is an evaluation instrument wick adds to the information about the patient and enables adaptation of the therapeutic strategy and also measurement of the treatment''s impact of lymphedema. [Copyright &y& Elsevier]

Atopic dermatitis (AD) is an inflammatory, chronic skin disease defined by flare-ups periods. The 5-year costs associated with the different emollients amounts to 1,329 and generates 3.55 QALY for emollient A. Patients spend in average 3.89 years without flare-ups periods. According to the analysis, treatment with preventive emollient was a cost-effective option compared with no treatment in adult AD patients. [Extracted from the article]

PMU27 BUDGET IMPACT ANALYSIS OF IMPLEMENTING THE CLOSED-SYSTEM TRANSFER DEVICE QIMONO® DURING CHEMOTHERAPY ADMINISTRATION IN A FRENCH HOSPITAL Contamination of nurses exposed to cytotoxic medications is a growing issue due to the increase use of injectable chemotherapy. In addition to a better nurses' health care, implementation of the CSTD during chemotherapy administration would save money to an hospital. [Extracted from the article]