Lymphedema is a frequent and chronic condition posing a high burden on patients. Clinical guidelines emphasize the role of compression therapy by prescription medical devices. Even in a mandatory publicly funded health insurance system, out-of-pocket payments (OOPP) may exist due to the price and reimbursement setting processes. OOPP may threaten the equity of care and drive patients to forgo care. Our aim was to analyze the distributive effects of OOPP for lymphedema patients in France.

A prospective, multicenter study will be conducted in France in 2014 on patients with lymphedema. Household ability to pay will be specified by net income and OOPP will be assessed prospectively over 6 months for outpatient care (visits, drugs, medical devices, nursing care, biological tests, imaging, physiotherapy and transportations). Both mandatory and voluntary health insurance reimbursements will be considered. We will combine concentration curves and concentration indices to assess the distributive effects.

Inclusion criteria:

• Patient aged over six years, with primary or secondary lymphedema, regardless of the severity of the disease;
• Patient treated in one of the centres participating in the study;
• Patient (and her legal representative for minors) who gave her written consent [or did not refuse to participate, according to local Law] ;
• Patient with Internet access and an active email address.

Exclusion criteria:

• Patients with concomitant chronic venous insufficiency;
• Patient not covered by any health care insurance scheme;
• People protected under the law.

All consecutive patients meeting the inclusion criteria will be included in each participating centre during the inclusion phase