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.
Certainly, for several weeks, the executive has 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%”assures 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, prescribed against prostate cancer, 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 13 million people), represented 31% of Medicare drug spending.
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How can the government address public concerns about the financial burden of increased co-payments for both medications and medical consultations?
**Interview with Geneviève Darrieussecq, Minister of Health**
**Editor**: Thank you for joining us today, Minister Darrieussecq. Your announcement regarding the changes in reimbursement rates for medicines drew significant attention. Can you explain the rationale behind lowering the reimbursement rates by 5%?
**Darrieussecq**: Of course, and thank you for having me. The decision to lower reimbursement rates is primarily a response to the ongoing and worsening Social Security deficit projected to reach 18 billion euros in 2024. We need to take measures to ensure the sustainability of our healthcare system. This step, while difficult, is essential to curb spending without compromising the quality of care.
**Editor**: Many patients are concerned about how these changes will affect their out-of-pocket expenses. Can you clarify what changes they can expect regarding their co-payments?
**Darrieussecq**: Yes, that’s an important point. The increased co-payment means that patients will have to cover a slightly higher portion of their medication costs after insurance reimbursement. However, I want to reassure the public that 100% covered medicines will not see any cuts. We are also working closely with complementary health insurance providers to minimize the impact on patients.
**Editor**: There was some controversy regarding the initial proposal to reduce the reimbursement rate for medical consultations. Can you tell us about the final compromise made in that regard?
**Darrieussecq**: Initially, we considered reducing the reimbursement for medical consultations from 70% to 60%, but I recognized the outcry from both the public and healthcare professionals. In light of this feedback, we revised our approach. The co-payment for medical consultations will now increase by only 5% rather than the initially proposed 10%. This compromise offers a more balanced approach to managing our budgetary constraints without overly burdening patients.
**Editor**: What can the public expect moving forward in terms of healthcare financing and management?
**Darrieussecq**: Moving forward, we will continue to evaluate and adjust our healthcare financing mechanisms to ensure they remain sustainable while maintaining access to quality care. We are committed to engaging with healthcare professionals and the public to find solutions that work for everyone. This conversation is ongoing, and input from all stakeholders is vital.
**Editor**: Thank you for your insights, Minister Darrieussecq. We appreciate your transparency on these complex issues.
**Darrieussecq**: Thank you for having me. It’s important to keep the lines of communication open as we navigate these challenges together.
