The announcement was unexpected. On the occasion of the opening of discussions in the Senate on the Social Security financing bill for 2025, the Minister of Health, Geneviève Darrieussecq, indicated, on Tuesday, November 19, that the reimbursement rates for medications for part of ‘health insurance would evolve’. Starting in 2025, these will be reduced by 5%, with the exception of 100% covered medications, which will escape the cut.
Given the worsening of the Social Security deficit, which is expected to reach 18,000 million euros in 2024 (compared to the 10,500 million initially planned), the Government is seeking savings measures to stop the increase in spending. However, the announcement of an increase in the co-payment for medicines has surprised, a sum that remains the responsibility of the patient after reimbursement by Health Insurance and which, in most cases, is covered by complementary health insurance.
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 medical consultation. The latter is currently reimbursed up to 70% by Health Insurance; It was initially planned to reduce its level of support to 60%. Faced with the protest, 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 scheduled for “spring 2025”We detail the ministry.
In exchange, drug coverage will also be reviewed. The existing reimbursement rates of 15%, 30% and 65%, defined according to the real benefit of the treatment (low, moderate and significant or greater), a criterion evaluated by health authorities when marketing it. drug, which had not changed since 2011, will thus increase, during the year 2025, to 10%, 25% and 60%. On the other hand, “Drugs that are currently covered at 100% will continue to be reimbursed at 100%”assures the ministry.
These medications, fully covered by Health Insurance, refer in particular to 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 anti-cancer drugs. medications such as Erleada, prescribed against prostate cancer, Ibrance (breast cancer) or even medications for rare diseases. In 2022, these 100% reimbursed health products, which also include drugs dispensed to patients with long-term illnesses (about 13 million people), accounted for 31% of Medicare drug spending.
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