Ethics and economic evaluation of health interventions for the definition of the scope of reimbursable care.

Summary Recent developments in welfare economics open the way to evaluation methods based on other models of social justice than utilitarianism. The feasibility of these methods in the daily practice of evaluating health interventions raises questions: the objective of this thesis is to contribute to answering them. To this end, we have focused on three practical cases. The aim of Chapter I is to compare the evaluation methodologies of three public evaluation agencies, the NICE (Great Britain), the IQWiG (Germany) and the KCE (Belgium), in order to identify the social justice positions that result from them. Chapter II proposes to study the moral dilemma that arises from the phenomenon of preference adjustment in the evaluation of two disability compensation schemes. Three options are put forward to solve this dilemma, based on egalitarian theories of social justice. Finally, Chapter III demonstrates the feasibility of the health-equivalent income approach, developed by Fleurabey, in public decision support, concerning antihypertensive treatments in primary prevention.