With the shift to ambulatory care in hospitals and actions on the price of drugs and generics, Marisol Touraine wants to save 3 billion euros in health.
The Social Security deficit will be less than 13 billion euros this year and reduced to under 10 billion in 2016, welcomed Marisol Touraine this Thursday morning on Europe1. But just before her hearing before the Social Security Accounts Commission, the Minister of Health had also conceded bad prospects for the sickness branch. Its deficit is expected to widen further to reach 7.4 billion in 2015, she said.
The Minister of Health then presented the receipts of her PLFSS 2016 (1) to save money. Objective, 3.4 billion euros in health within three years.
3.4 billion expected savings
First axis of this project, to avoid “unnecessary or redundant acts” such as pre-anesthetic and biological examinations and the use of medical transport. “We expect, as in 2015, 1.2 billion euros in savings in this regard in 2016”. By tackling these dysfunctions, the minister is in fact taking up a favorite subject of the Court of Auditors which recently called into question in a report “the transport of patients by taxi too numerous”. The wise men of rue Cambon (Ier, Paris) were therefore heard.
New anti-diabetics in the sights
Second economic track: “the price of health products and the development of generics”.
As such, the Minister hammered home her desire to lower the price of drugs that are too expensive “so that they are accessible to all patients”. The opportunity for her to refer to the recent battle won by the government over the price of hepatitis C treatment “Sovaldi” which is now marketed in France at the lowest price in Europe.
Among the other drugs in the sights, the new anti-diabetics. The government hopes to make more than 80 million savings, from the 1st year, by encouraging doctors to only prescribe the new molecules to certain patients. They are, it is true, much more expensive than the previous products. “A policy against the meaning of the latest medical studies”, deplores for his part Professor André Grimaldi, former head of the diabetology department of Pitié-Salpétriêre (Paris).
Prof. André Grimaldi, diabetologist at Pitié-Salpétriêre: ” Sécu says there are millions of savings on this item. A month later, a study on these drugs is released which shows an important benefit for the patient and the health system… “
On the generic side, the Minister called for their use to be intensified. Doctors, in town and in hospitals, will therefore be more encouraged to prescribe them and a major communication campaign will be launched during the first half of 2016 to raise awareness among the French, she said. They would allow 39 million savings over a year. But the industrialists, them, bet on “even more”, indicated to Pourquoidocteur Catherine Bourrienne-Bautista, general delegate of Gemme (2).
Catherine Bourrienne-Bautista, General Delegate of Gemme: ” This figure relates specifically to the hospital. The Gemme “Generics” plan proposes a three-year objective of a saving of 350 million euros if it is extended to the city… “
The acclaimed ambulatory shift
Finally, the Minister ended the presentation of her PLFSS 2016 by reiterating once again her desire to promote the shift to ambulatory care. “This is what makes it possible to meet the demand of patients to spend less time in the hospital and more time at home, with their loved ones.”
The first fitting of a hip prosthesis in outpatient surgery, which recently took place at the AP-HP (3), further extends the horizon of possibilities, according to her. She recalled that the patient in question even walked home. “The outpatient surgery rate was 40.8% in 2012. It rose to nearly 45% in 2014. The objective of one out of two outpatient surgery, which I had set, is therefore on track. ‘to be affected,’ she predicts.
Among the known avenues, young mothers who should be encouraged, if their condition allows it, to leave maternity earlier. That is to say after 3 days against 4.2 today. According to a CNAMTS report published in July, this measure would result in savings of 78 million euros in one year. A figure on which the union of gynecologists and obstetricians is “dubious”, entrusted to the drafting Elisabeth Paganelli, general secretary of the national union of obstetrician gynecologists of France (Syngof).
Elisabeth Paganelli, general secretary of Syngof: ” You are never sure of the savings announced. And the problem is that in France, the early return home is not very well coordinated. We don’t know how much it will cost… “
Patients undergoing orthopedics should also be involved. This ambulatory shift is not, however, only happy. The French Hospital Federation (FHF) has recalled in the past that this change would result in the closure of beds, especially in surgery. A scenario feared by many local elected officials in the territories. However, the stakes are high for Marisol Touraine, who plans to save 500 million euros from 2016.
As a reminder, the social security financing bill will be presented to the Council of Ministers on October 7.
(1) Social security financing bill
(2) Association which brings together generic professionals
(3) Public Assistance – Paris Hospitals
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