2024-11-20 05:20:00
Mammogram of a patient at the Lorraine-Alexis Vautrin cancer institute, in Vandoeuvre-lès-Nancy (Meurthe-et-Moselle), October 4, 2023. ALEXANDRE MARCHI / PHOTOPQR / L’EST REPUBLICAIN / MAXPPP
The announcement was unexpected. On the occasion of the opening of discussions of the Social Security financing bill for 2025 in the Senate, the Minister of Health, Geneviève Darrieussecq, indicated, Tuesday, November 19, that the reimbursement rates for medicines by the ‘Health insurance would evolve. From 2025, these will be lowered by 5%, with the exception of drugs covered at 100%, which will escape the cut.
Faced with the worsening of the Social Security deficit, expected in 2024 to reach 18 billion euros (compared to 10.5 billion initially planned), the government is seeking savings measures to curb the surge in spending. The announcement of an increase in the co-payment on medicines, this sum remaining the responsibility of the patient after reimbursement by Health Insurance, and which, in most cases, is covered by complementary health insurance, has however surprised.
For several weeks, the executive has certainly been thinking about activating this lever. But the increase in user fees was only mentioned in the context of the medical consultation. The latter is now reimbursed up to 70% by Health Insurance; it was initially planned to reduce its level of support to 60%. Faced with the outcry, the Minister of Health finally opted for a compromise: the co-payment of the medical consultation, “which was supposed to increase by 10%, will only evolve by 5%”said Geneviève Darrieussecq on Monday. The entry into force of this measure, which will be the subject of a ministerial decree, is planned for “spring 2025”we detail to the ministry.
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In return, medication coverage will also be revised. The existing reimbursement rates of 15%, 30% and 65%, defined according to the actual benefit of the treatment (low, moderate, and significant or major), a criterion evaluated by the health authorities when placing it on the market. of a drug, and which had not changed since 2011, will thus increase, during the year 2025, to 10%, 25% and 60%. On the other hand, “medications which are currently covered at 100% will continue to be reimbursed at 100%”indicates the ministry.
These medications, 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, certain anticancer drugs such as Erleada, indicated in prostate cancer, or Ibrance (breast cancer), or even drugs for diseases rare. In 2022, these health products reimbursed at 100%, which also include drugs dispensed to patients with long-term illnesses (around thirteen million people), represented 31% of Medicare drug spending.
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How will these changes in reimbursement and co-payment structures influence the overall accessibility of healthcare services for low-income individuals?
**Interview with Geneviève Darrieussecq, Minister of Health**
**Editor:** Thank you for joining us today, Minister Darrieussecq. Your recent announcement regarding changes in reimbursement rates for medications has raised quite a few eyebrows. Could you explain the reasoning behind these changes and the expected impact on patients?
**Minister Darrieussecq:** Thank you for having me. The decision to lower reimbursement rates for medications by 5% starting in 2025 was not taken lightly. With the Social Security deficit projected to rise significantly next year, reaching 18 billion euros, we must look for savings to maintain the sustainability of our healthcare system. This adjustment aims to balance our financial obligations while ensuring that essential medications remain accessible to the public.
**Editor:** Many patients are understandably concerned about the increase in co-payments for medicines. Can you elaborate on how this change will affect those who rely on medications regularly?
**Minister Darrieussecq:** Certainly. While co-payments will increase, it’s important to note that this only affects medications not covered at 100%. Most patients have complementary health insurance that alleviates these out-of-pocket expenses. Our goal is to ensure that necessary medications remain affordable, despite these adjustments. We strongly encourage patients to discuss their coverage options with their insurers.
**Editor:** There was also a significant discussion around the co-payment for medical consultations. Initially projected to decrease health insurance support from 70% to 60%, the decision was made to only increase by 5%. What led to this change?
**Minister Darrieussecq:** The reactions from the public and healthcare professionals were indeed strong, which played a crucial role in our decision-making process. We want to maintain access to medical consultations without putting additional financial strain on patients. Ultimately, we found a compromise that addresses the need for fiscal responsibility while also responding to the concerns raised by the community.
**Editor:** How do you foresee the public reacting to these changes, and what measures are in place to support those who may struggle with increased costs?
**Minister Darrieussecq:** We expect a variety of reactions, as healthcare is a deeply personal issue. To mitigate the impact of increased co-payments, we are working closely with complementary health insurance providers to ensure they can adapt swiftly. We also plan to increase public awareness and provide resources on navigating these changes effectively.
**Editor:** Thank you for sharing your insights, Minister Darrieussecq. It’s clear that while the government is seeking solutions for fiscal sustainability, the implications for patients are significant and will need careful management.
**Minister Darrieussecq:** Thank you for the opportunity to clarify our position. It is vital that we maintain an open dialogue with the public about these adjustments and their impacts on healthcare access.
