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 rare diseases. 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 the government ensure that the moderation in co-payment increases addresses public concerns while also saving costs?
**Interview with Geneviève Darrieussecq, Minister of Health**
**Editor:** Thank you for joining us today, Minister Darrieussecq. There has been significant discussion surrounding your recent announcement about the changes in reimbursement rates for medicines under the Social Security financing bill for 2025. Can you elaborate on the reasons behind this decision?
**Minister Darrieussecq:** Thank you for having me. The decision to lower the reimbursement rates for medicines by 5% stems from the need to address a growing Social Security deficit, which is projected to reach 18 billion euros in 2024. As we face fiscal challenges, it’s crucial to implement measures that ensure the sustainability of our healthcare system while still maintaining support for patients.
**Editor:** Many people are concerned about how these changes will affect their access to medications. What safeguards are being put in place for those who rely heavily on prescribed drugs?
**Minister Darrieussecq:** That’s an important concern. While the general reimbursement rates will see a reduction, drugs that are covered at 100% will remain unaffected. Additionally, we are committed to ensuring that co-payments don’t become a barrier to access. Our goal is to work closely with complementary health insurance providers to help mitigate the financial impact on patients.
**Editor:** There was also considerable pushback regarding the potential increase in the co-payment for medical consultations. How do you plan to address this backlash while still finding necessary savings?
**Minister Darrieussecq:** We certainly listened to the concerns raised by healthcare professionals and the public. Initially, we considered a 10% increase in co-payments, but after evaluating the situation and taking public feedback into account, we decided on a more moderate increase of just 5%. This compromise allows us to save funds while still being sensitive to the needs of patients.
**Editor:** Looking ahead, what steps is the government planning to take to further stabilize the finances of the Social Security system?
**Minister Darrieussecq:** Beyond these measure adjustments, we are conducting a thorough review of expenses within the healthcare system. This includes looking into areas such as administrative costs and unnecessary spending, while simultaneously investing in preventive care initiatives to reduce long-term costs. Our aim is to create a more balanced and efficient healthcare financing system.
**Editor:** Thank you, Minister Darrieussecq, for your insights today. It’s clear that these changes are part of a broader strategy to stabilize the healthcare system while attempting to minimize the impact on patients.
**Minister Darrieussecq:** Thank you for having me. It’s a challenging time, but we are dedicated to finding solutions that serve both the health of our citizens and the sustainability of our healthcare system.
