“Another path must be considered, that of greater efficiency in health spending”

2024-10-13 04:00:00

theToday, France allocates 12% of its gross domestic product (GDP) to financing health spending, or more than 300 billion euros per year. Since the 1970s these expenses have increased by 130%. This increase has been very advantageous for the French: there is in fact a strong correlation between the growth rate of healthcare spending and the increase in life expectancy of the populations that benefit from it.

Historically, health care spending follows economic growth. In a perfect world, a virtuous circle begins: spending helps improve the health of the population, and the resulting productivity gains fuel economic growth, because there is a direct link between health, education and labor productivity. This growth then makes it possible to increase investments in healthcare. And so on…

In times of crisis, health spending decreases less rapidly than GDP, because the social protection system plays its role as a shock absorber. The financing of healthcare spending then involves debt which, by allowing investments in the healthcare system to be maintained, creates favorable conditions for the recovery of economic growth. But three reasons make this recovery scenario uncertain today.

Decline in the attractiveness of the French market

First of all, a growing share of health spending is intended to finance the needs of non-self-sufficient elderly people, whose contribution to economic growth is a priori reduced. Then, the hospital’s very poor financial situation and the lack of healthcare services lead to massive long-term investment needs, precisely at the moment when rising interest rates are deteriorating debt conditions. Finally, pharmaceutical innovations entering the market are priced at unprecedented levels, compromising the system’s ability to fund access.

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Our health policies are currently responding to these challenges by activating two main levers: increasing the contribution of manufacturers and private insurers to financing health insurance costs and increasing the remainder paid by patients. These two levers are highlighted even more by the Social Security Financing Bill of 2025 (PLFSS).

In a context where the French market represents only 3% of the global medicines market, this strategy could ultimately contribute to reducing access to care for French patients. Indeed, regulatory instruments such as the “safeguard clause” or the delisting of medicines reduce the attractiveness of the French market for manufacturers, who risk encouraging entry into more vibrant markets.