2023-08-16 08:50:47
France had to resolve to do so when it sent its budgetary stability program to Brussels: discreetly, the increase in health expenditure for 2024 was revised upwards, from + 2.7 to + 3.1 %, according to The echoes. Suffice to say that the health insurance budget is watched like milk on the fire by Bercy, which is studying all the solutions to prevent slippages.
In the line of sight, in addition to sick leave, are drug expenses, pointed out in mid-June by the Minister of the Economy Bruno Le Maire during the public finance meeting. “Their free, or almost free, can lead to the patient taking responsibility and explains why the purchase of drugs is still so high in France”, he worried.
Bercy would therefore think very seriously about an increase in the deductible on drugs, currently 50 cents per box. This could be doubled, like that of 50 cents on paramedical acts, €2 on transport or the “flat-rate contribution” of €1 on consultations, radiological acts or analyses, and be extended to medical devices (crutches , implants, etc.). The goal: to achieve 1.5 billion euros in additional savings.
Each year, €450 of medication prescribed per patient
“It’s not necessarily a bad policy that people are aware of what drugs cost,” recognized the director of Social Security Franck Von Lennep at the end of June, before the Association of Journalists of Social Information (Ajis).
Still, to achieve the savings objective, it would also be necessary to double the deductible ceiling of €50 per year applied to each patient, with the risk of penalizing those who suffer from chronic diseases or of making them give up treatment. Not touching this ceiling would reduce the economy to 600 million euros.
“All the levers are being studied” to save money on drugs, assured Franck Von Lennep, who also wants to tackle the volume of prescriptions, each French doctor prescribing €760,000 of drugs each year, or €450 per patient.
Last month, the “expenses and products” report, which lists each year the proposals of health insurance to the government to achieve a balanced budget, therefore proposed to better support doctors in the prescription, in particular through the development of software . It also announces to fight against the diversion of drugs to a use other than that indicated in the marketing authorization.
Franck Von Lennep also sketched “the establishment of an incentive system for prescribers” as well as the possibility of using “more prior agreement”. And he announces “proposals on prices, without ignoring the important demands of manufacturers” who are calling for price increases.
No decrease in drug reimbursement
Health insurance also wants to trivialize biosimilar drugs, the generic version of drugs derived from biotechnology, which could allow “several hundred million euros in savings in the medium term”.
The director of Social Security, on the other hand, ruled out any reduction in the reimbursement rate for medicines, like what will be done from October 1 for dental care: Social Security will only reimburse them at 60% (instead of 70%), the share of mutuals increasing from 30 to 40%.
“Social Security is not in the process of disengaging”, yet assured Franck Von Lennep in front of Ajis, recalling that, “Since 2010, Social Security has seen its share increase in health spending”. According to the DREES, the statistical service of the social ministries, this share has indeed increased from 73.3 to 79.8% over the period, against a decrease from 13.6 to 12.9% for complementary.
He therefore wishes “to ensure that each of the payers, Social Security and complementary organizations, has an equivalent expenditure dynamic”.
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