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Elise Cabout,1 Sebastien Eymere,1 Robert Launois,1 Flavia Aslanian,2 Charles Taïeb,3,4 Sophie Seité5 1Réseau d’évaluation en Économie de la Santé (REES), Paris, France; 2Epsom and St Helier University Hospitals NHS Trust, London, UK; 3EMMA, Fontenay-sous-Bois, France; 4Hôpital Necker Enfants-Malades, Santé Publique, Paris, France; 5La Roche-Posay Dermatological Laboratories, Levallois-Perret, FranceCorrespondence: Sophie SeitéLa Roche-Posay Dermatological Laboratories, 62 Quai Charles Pasqua, Levallois-Perret 92300, FranceTel +33 1 49 64 33 40Email sophie.seite@loreal.comIntroduction: Atopic dermatitis (AD) is chronic inflammatory skin condition, characterized by its remission-relapse cycles. This predominantly pediatric disease is becoming more and more prevalent. Emollients are part of the therapeutic management and particularly a way to increase time between relapses. The follow-up of AD and relapses have a great impact on patient’s quality of life, expenditures and society costs. The aim of this study is to assess the cost-effectiveness of different emollients prescribed to AD patients.Methods: A three-state Markov simulation model was developed over a six-year period with 28 days cycles. Two perspectives were adopted, a health care system perspective and a societal perspective. Four different emollients (A, B, C, D) were compared with no emollient use. Time without flare-up was the key endpoint of the study. quality adjusted life-years (QALYs) were assessed as a secondary outcome. Cost and effectiveness data were derived from (i) randomized clinical trials and literature review for the efficacy of treatments, (ii) resource utilization and quality of life data, and (iii) unit prices from official price lists.Results: The six-year health care costs associated with emollient A amount to £ 1844.23 and generate 4.58 years-without flare-up. Co

In the current context of the growing of health care expenses, the allocation of scarce resources in the most efficient way becomes essential. Consequently, the routinely use of full economic evaluations in decision processes should be promoted. However, information provided by economic evaluations is not used in an optimal way by health care decision makers, mostly because of their lack of transferability to other countries and the difficulty of judging about their quality. The aim of the thesis was thus to investigate a number of methods in the field of economic evaluations which could be used to improve the information transmitted to Belgian health care decision makers. Three tools were investigated in this research: the use of Belgian administrative databases, the use of Markov models, and the use of quality assessment instruments. The first part of the thesis analyzed the use of Belgian administrative databases to assess the quality of prophylactic treatment in prevention of venous thromboembolism after major orthopedic surgery. In the second part, the use of Markov models to assess the treatment of patients with chronic hepatitis C was analyzed and finally, in the third part, three quality assessment instruments were compared and used in a systematic review of economic evaluations on the surgical treatment of obesity. Such investigations allowed us to formulate methodological recommendations but also suggestions to improve the quality of care. While recommendations concerning the use of Belgian administrative databases and the use of Markov models were mostly specific to the Belgian context, recommendations on the use of quality assessment instruments had an international impact. Health care decision makers could use the information provided by this research in decision processes concerning the reimbursement of health care programs but also in the process of determining new clinical practice and health economic guidelines. This research would thus be interesti, (SBIM 3) -- UCL, 2008