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 / 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, Monday, November 18, 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 rare diseases. 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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**Interview with Geneviève Darrieussecq, Minister of Health**
**Editor:** Thank you for joining us today, Minister Darrieussecq. The recent announcement regarding the changes in reimbursement rates for medicines has certainly raised eyebrows. Can you tell us what prompted this decision?
**Minister Darrieussecq:** Thank you for having me. The decision to adjust reimbursement rates primarily stems from the alarming increase in the Social Security deficit, projected to reach 18 billion euros in 2024. We need to find sustainable measures to manage healthcare spending while ensuring that essential medications remain accessible to patients.
**Editor:** I see. Many people are concerned about the impact of these changes on their out-of-pocket expenses. Can you clarify what these changes will mean for patients?
**Minister Darrieussecq:** Absolutely. Starting in 2025, there will be a 5% reduction in reimbursement rates for most medications, except for those covered at 100%. This means that patients will likely have to pay a little more for their medicines, although complementary health insurance often covers a portion of these co-payments.
**Editor:** That’s a significant change. Initially, there were also plans to reduce reimbursement for medical consultations. Why was this reconsidered?
**Minister Darrieussecq:** Yes, the initial proposal was to reduce the reimbursement from 70% to 60%, but we listened to the feedback from both healthcare providers and patients. In response to the outcry, we’ve decided to implement a compromise that limits the increase in co-payment for medical consultations to just 5%.
**Editor:** Do you believe these measures will effectively address the looming deficit while still providing adequate care for patients?
**Minister Darrieussecq:** It’s a delicate balance, but we do believe these adjustments will help us manage the deficit without compromising the quality of care. Our primary goal is to ensure that vital services and medications remain available while finding ways to make the healthcare system sustainable.
**Editor:** Thank you, Minister Darrieussecq, for shedding light on these changes. Your insights help clarify how the government is navigating these challenging financial times in healthcare.
**Minister Darrieussecq:** Thank you for having me. It’s important we keep the dialogue open as we work through these necessary reforms.
