OBJECTIVES: To assess the costs, consequences and cost-effectiveness of Elidel (pimecrolimus cream 1%) in treatment of children with atopic dermatitis in Hungary. METHODS: A Markov model for atopic dermatitis developed by the Erasmus University (Rottetrdam, the Netherlands) was adapted to the Hungarian health care settings. The model based on a double-blind, multicenter, randomized, parallel-group study. Patients were randomised (2:1) to receive pimecrolimus treatment paradigm (i.e. emollients, pimecrolimus, medium potency topical corticosteroids) or standard of care (emollients, vehicle, medium potency topical corticosteroids). The study was conducted in children and adolescents (2 to 18 years of age). Hungarian cost vectors were calculated by linking severity of disease as defined by Investigator's Global Assessment (IGA) to average resource use. Resource use was multiplied by drug costs and unit costs as published in official databases. RESULTS: Pimecrolimus treatment has an incremental cost of HUF 143,897 over standard care. This additional cost of care resulted in an incremental 0.05 QALY gain over the 6 months period.. The incremental cost effectiveness ratio was 2,863,913 HUF/QALY for the pimecrolimus therapy. CONCLUSION: Pimecrolimus is more cost-effective than many other health care interventions currently reimbursed by the Hungarian National Health Fund.