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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What are the expected long-term effects of the changes in reimbursement rates on the French healthcare system?
**Interview with Geneviève Darrieussecq, Minister of Health**
**Editor:** Thank you for joining us today, Minister Darrieussecq. Your recent announcement regarding the changes in reimbursement rates for medications has sparked quite a bit of discussion. Can you explain the reasoning behind the decision to lower reimbursement rates by 5% starting in 2025?
**Geneviève Darrieussecq:** Thank you for having me. The decision to adjust the reimbursement rates is primarily driven by a significant rise in the Social Security deficit, projected to reach 18 billion euros in 2024. Our goal is to find savings measures that will help manage and curb the increasing expenditures in the healthcare system while ensuring that essential medicines remain accessible.
**Editor:** It’s been noted that the increase in co-payment was unexpected, especially since it had only been raised in the context of medical consultations. What led to the decision to increase co-payments on medications as well?
**Geneviève Darrieussecq:** We have been exploring various avenues to enhance the sustainability of our healthcare financing. While we initially focused on consultations, we realized that adjusting the co-payment for medications could also play a crucial role in this effort. It was essential to find a balanced approach, ensuring that patients are still able to access necessary treatments while managing the fiscal responsibility of healthcare funding.
**Editor:** There has been significant public reaction to these proposed changes. How do you anticipate they will impact patients, and what measures will be in place to support those who may struggle with these new costs?
**Geneviève Darrieussecq:** We understand that any increase in costs can be concerning for patients. However, it’s important to note that drugs covered at 100% will not face these cuts. Additionally, the co-payment increases will be gradual, and we are working closely with complementary health insurance providers to ensure that the burden on patients is minimized. Our priority remains to ensure universal access to healthcare services.
**Editor:** Thank you for sharing these insights, Minister. As these discussions continue, what message do you have for the public regarding the future of the French healthcare system?
**Geneviève Darrieussecq:** I want to assure the public that we are committed to maintaining a high-quality healthcare system in France. Balancing fiscal responsibility with patient care is challenging, but necessary. We are listening to the concerns of citizens and will continue to make adjustments that prioritize both health and sustainability in our system.
**Editor:** Thank you for your time, Minister Darrieussecq. We appreciate you shedding light on these important matters.
