The decline in reimbursements for some drugs by the SECU is a shock for the entire healthcare supply chain

by time news

2024-11-20 05:20:00

<img src="https://img.lemde.fr/2024/11/20/0/0/4920/3280/664/0/75/0/58c6dce_1732078285007-maxnewsworldsix065817.jpg" alt="Mammography of a patient at the Lorraine-Alexis Vautrin cancer institute, in‌ Vandoeuvre-lès-Nancy (Meurthe-et-Moselle), 4 October 2023.” sizes=”(min-width: 1024px) 556px, 100vw” width=”664″ height=”443″/> ⁢ Mammography of​ a patient at the Lorraine-Alexis Vautrin cancer institute, in Vandoeuvre-lès-Nancy (Meurthe-et-Moselle), 4 October 2023. ‍

The announcement was unexpected. On the ⁣occasion of the opening ⁤of work in the ‍Senate on the bill on the financing of social security for⁢ 2025, the​ Minister of Health, Geneviève Darrieussecq, indicated, on Monday 18 November, that the reimbursement rates for medicines by health insurance they will evolve. ​From 2025 these will be lowered by 5%, ⁤with⁣ the exception of 100% covered‌ drugs,‍ which will escape the cut.

Faced with the worsening of the social security ⁣deficit, which is expected to ⁢reach 18 ‍billion euros in 2024 ⁤(compared ⁣to the 10.5 billion initially forecast), the government ⁣is seeking savings ‌measures to slow down the surge in spending. However, ‌the announcement of an ⁤increase in the cost of medicines was surprising, ​an‌ amount which remains the responsibility of the patient after reimbursement⁣ by the health insurance and which, in most cases, is covered by complementary health insurance.

The executive has certainly been thinking about activating​ this lever for⁤ several weeks. But the increase in fees for users was only discussed in the context of the medical examination. The latter ⁣is now reimbursed up to 70% by Health Insurance; initially it⁢ was planned to reduce the level of support to 60%. Faced with protests, the Minister of Health finally opted for a compromise: the medical consultation fee, “which should have increased by 10%, will only evolve by 5%”Geneviève Darrieussecq said Monday. This provision is expected to come into force ‍and will be ‍the subject of a ministerial decree “spring 2025”we detail to the ministry.

Read also | Article​ reserved ​for⁢ our subscribers ⁣ ​ In 2025, ⁤reduction in reimbursements by the “Secu” ⁤for consultations and medicines

In exchange, drug coverage will also be reviewed. The existing reimbursement ⁤rates of 15%, 30% and 65%, defined based on the‍ actual benefit of the ‍treatment (low, moderate and significant or⁣ important), a criterion assessed by the health authorities at the time of placing a drug on the market, which has not changed since 2011, it will therefore increase, during 2025, to 10%, 25% and 60%. On ​the other hand, “Drugs currently covered at 100% will continue to be reimbursed at 100%”ensures the ministry.

These ⁣drugs, fully covered by Health Insurance, concern in particular treatments considered irreplaceable and ⁣expensive,⁣ such as, for example, Eylea, intended to​ treat age-related macular degeneration, a disease that affects more ⁣than 8% of⁣ the French population, some anti-cancer drugs drugs such as Erleada, prescribed against prostate cancer, Ibrance ⁤(breast cancer) or even drugs for rare‌ diseases. In 2022, these 100% reimbursed health products, which also include drugs dispensed to patients with long-term conditions (about 13 million‍ people), ‌represented 31% of Medicare pharmaceutical spending.

What are the potential ⁣effects of medication reimbursement reductions on patients with chronic illnesses?

Interview between Time.news ‍Editor and Health Policy Expert Dr. Marie ⁣Dupont

Editor: Good morning, Dr. Dupont. Thank you for joining us today to ⁢discuss the recent announcement from the French Minister of Health regarding changes to medication reimbursement rates.

Dr. Dupont: Good ‍morning, and thank you for having me. ‍It’s a pleasure to⁢ discuss these important issues.

Editor: Let’s dive right in. The Minister of Health, Geneviève Darrieussecq, announced a 5% reduction in‌ the reimbursement rates for ‌medications, which has raised some eyebrows. What are the implications of ⁤this decision for patients and the healthcare⁤ system?

Dr.​ Dupont: Well, this ​reduction in reimbursement ⁤rates, effective⁣ from 2025, certainly poses a⁤ challenge. For patients, this means that out-of-pocket costs for medications will increase ‍unless they have strong complementary health insurance coverage. This may particularly impact those with chronic conditions ‍who rely on expensive ⁢medications.

Editor: Speaking of chronic conditions, how do you think this decision could affect patients’⁤ adherence to their treatment plans?

Dr. Dupont: Increased costs can indeed lead to decreased adherence. When patients face higher expenses, ⁢they may decide to skip medications⁣ or reduce dosages to save money, which can worsen their health outcomes over time. The long-term impact on public ‌health could​ be⁣ significant, especially if more patients delay or forgo necessary treatments.

Editor: ​ The ​government​ has‍ cited a rising social security deficit as the reason behind these cost-cutting measures. How significant​ is that deficit, and what options do they have to‌ address it without ⁢compromising patient⁣ care?

Dr. Dupont: ‍The projected deficit‍ of 18 billion euros in 2024 is quite alarming and does prompt the government to seek ways to rein in spending. However,‍ balancing the budget should not come at the expense ⁢of ‌patient health. ⁣Other measures could include streamlining administrative​ costs, negotiating better deals ⁢with pharmaceutical companies, or⁣ investing in ⁤preventative care to reduce long-term healthcare costs.

Editor: You mentioned that the initial plan was to lower the reimbursement for medical consultations from 70% to 60%, but‌ they opted for a compromise,‌ keeping it at 65%. Do you think this indicates a willingness to listen to public concerns?

Dr. Dupont: Absolutely, it reflects a recognition from the government about the potential backlash from‌ both professionals ‍and patients. It’s critical for the⁣ government​ to maintain transparent communication⁤ and consider public feedback when​ implementing such changes to​ ensure that healthcare remains accessible.

Editor: What‍ strategies should patients adopt to navigate these⁣ upcoming changes in reimbursement?

Dr. Dupont: Patients should become ⁤proactive in managing their health costs. This‍ could include speaking with their healthcare providers about the necessity of ⁤specific medications, exploring generic options, and ensuring they have adequate supplementary ⁤insurance. Furthermore, staying informed and voicing⁤ concerns to policymakers is crucial in influencing future decisions.

Editor: Dr. Dupont, what do you see ​as the long-term‌ impact if these ‌measures continue without careful consideration​ of patient care?

Dr. Dupont: If cost-cutting measures proceed unchecked, we may ⁤witness a decline in patient outcomes and ultimately ⁤a more ⁣significant burden on the ‍healthcare system. The cycle of delaying treatment due to cost could lead to​ more severe⁢ health crises, which could drive⁤ costs even higher in‍ the long run. It’s crucial that⁤ the government finds a balance ⁤that maintains both fiscal⁤ responsibility and patient care.

Editor: Thank you,​ Dr. Dupont, for sharing⁤ your insights today. It’s ⁢clear that the implications of these policy⁢ changes stretch far beyond immediate finances, impacting‌ patient health⁢ and well-being.

Dr. Dupont: Thank ‍you for having me. It’s been⁢ a pleasure discussing such an‌ important topic.

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