Abstract
Managed care, a regime with multiple facets, integrates the delivery of care, whatever fields it concerns (services, hospitalisations, drugs), and the financing to supply medical services of high quality while containing expenses. Its success reached its climax in the 1990s. This paper discusses the history of managed care, analyses the mechanisms of cost reduction that appeared in the aftermath of managed care, notes criticisms from practitioners and insurers and, finally, describes some European experiences inspired by US managed care.