Medications are also waiting for a clear break. While the Social Security Financing Law (PLFSS) “promises to be catastrophic” according to Leem, the union representative of the pharmaceutical laboratories in France, Thibaut Victor-Michel, CEO of Novartis France, demands a change in the paradigm.
Increasingly important price reductions
Several years have passed since the pharmaceutical sector has been beaten by the price drops decided within the framework of Social Security financing (PLFSS). Of little more than 600 million euros in 2021, these price reductions now exceed one billion euros in 2025. These price reductions are accompanied by a market restructuring thanks to a predominance of generic drugs, these copies of princeps (brand) medications whose prices are approximately 30% cheaper. This policy is applied to limit the volume of reimbursements in health insurance expenses.
And that is not all: laboratories also pay an support clause when the billing made by the medications reimbursable by the SEPO increases faster than the progression rate defined every year in the law. Although it amounted to 1,600 million euros last year, this year it should rise to 1.8 billion euros in the next security budget by 2026.
Innovative drug degraded access
Consequently, according to manufacturers, France becomes less and less attractive. “We have a loss of competitiveness, we were the first European drug producer fifteen years ago, we went in sixth place. And we were the first in clinical research, we went to third place.” As a result, access to the most innovative drugs is deteriorating.
It should be said that the process to market an innovative medicine is very supervised in France. Because the authorization to marry only the European market does not guarantee the availability of a promising treatment in France.
To be reimbursed by the particular health insurance, the treatment must be subject to the opinion of the high health authority that evaluates the provided medical service (SMR), and in particular the improvement of the Medical Service provided (ASMR) compared to other existing treatments and marketed in the French market. Then, the body recommends a reimbursement rate, usually corresponding to the drug efficiency level: 15% if the SMR is low, 30% if moderate, 65% if it is important or important and 100% if it is considered irreplaceable and expensive.
However, in 2021, an early access system had been established to provide patients with the most innovative treatments, even before the European drug agency officially issues a marketing authorization (AMM). But according to Thierry Hulot, president of the Leem and the saying of the lymphoma, “since the beginning of the year, there has only been two authorized early access.” It should be said that the derivation of the deficit in the social person encourages public authorities to always review the prices of medicines and, therefore, harden their belt in terms of financing innovative treatments.
Source: BFM TV
