2024-11-20 05:20:00
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.
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.