From 2020, patients who refuse a generic drug in pharmacies without medical justification will be less well reimbursed. This measure, presented as part of the 2019 Social Security Financing Bill, is already being debated.
It is a controversial measure, thought to increase the share of generics in the sale of drugs. From January 1, 2020, patients who are offered a generic in pharmacies instead of the original drug (princeps) and who refuse it without medical justification will be less well reimbursed.
This measure included in the Social Security Financing Bill for 2019 is already controversial even before its implementation. Indeed, it provides that patients refusing generics will no longer be reimbursed on the basis of the price of the originator, but on that of the most expensive generic and will therefore have to pay the difference out of their pocket.
Doctors are also concerned. While the latter can currently add the mention “non-substitutable” on the prescription (8% of cases) to refuse replacement with a generic drug, they will now have to justify this mention by “objective medical criteria”, defined with the National Agency for the Safety of Medicines and Health Products (ANSM).
80 million euros in savings expected
Purpose of such a measure? Promote the prescription and sale of generic drugs to save money, because they cost on average 30% less than brand-name drugs.
Currently, generics represent only 36% of the sales volume of drugs in France, compared to 86% in Germany and the United Kingdom. And this, in spite of the multiple national information campaigns highlighting the dispensation of advance fees (third-party payment) against the prescription of generics, or even the financial incentives given to pharmacists and doctors. Faced with the relative effectiveness of these devices, the Ministry of Health and Solidarity has therefore taken the lead in achieving part of the 3.8 billion in savings requested, and partly imputing it to the sale of originator drugs. He hopes to save 80 million euros each year.
A “bureaucratic drift” and a “punishment” for patients
But among patient associations, the measure is struggling to pass. For the organization France Assos Santé, which represents 80 patient associations, patients forced to take generics are “sanctioned”, which is not the case for health professionals. According to her, this is a “new punishment” which will “only fuel doubts” about the credits.
For their part, the main unions of doctors and pharmacists denounce a “bureaucratic drift” which risks creating “conflicting and time-consuming situations” with customers.
Questioned by AFP, Jean-Paul Ortiz, president of the Confederation of French Medical Unions (CSMF) insists on the “risk of confusion” with elderly patients. He is joined by Jacques Battistoni, president of the MG France union, who affirms that the latter find themselves “lost” if the products change “shape, color” and name “every 3 months”.
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