Études coût/efficacité: idées fausses et éléments de méthode

The cost-effectiveness of treatment studies became useful, common and sometimes mandatory to inform public policy makers about the economic impact of treatment implementation as well as on their collective impact on health. This review presents the basic principles underlining these studies, showing that they do not have to reduce health cost, but to help evaluating treatments efficiency, and thus to compare measurement of the expected benefits compared to the expense. The term of reference used by economists is QALYs, i.e., amount of years of life saved adjusted by the quality of life. QALYs measurement is based on the subjective assessment of health status resulting from an intervention by the patient himself. In case of a primary preventive intervention, the cost-effectiveness analysis will assess both the savings related to avoided events costs at the expense of longevity and quality of life.