Changing the packaging of drugs to save money is the experiment that Marisol Touraine is launching. This track has often been mentioned, but has never convinced.
Going from theory to practice is what Marisol Touraine offers. The Minister of Health has announced her desire to experiment with dispensing drugs individually and no longer by box, starting with certain antibiotics, in certain regions. However, for years, this track has been mentioned in many official reports.
One in two drugs is not consumed
In a report from the Igas 2005, the dispensing of the drug in a box is singled out. “Unlike other countries, France has chosen, for health reasons, that the delivery of the drug is not limited to the number of tablets prescribed and the size of the packages is jointly determined by the administration and the drug manufacturers. , explain the authors. And, taking into account third-party payment and advance-fee waiver measures, consumers often do not know the amount of their expenditure. These various phenomena put together, we can estimate that almost one out of two reimbursed drugs is not taken. “A waste which obviously costs the community dearly since some of these drugs are reimbursed by health insurance.
For its part, Afssaps (ANSM today) estimated in 2007 that “it would be desirable, as far as possible, to move towards unitary packaging for any pharmaceutical specialty. “For the Medicines Agency, this measure would” limit medication errors by helping to maintain the effectiveness of the treatment and prevent an avoidable toxic risk. Unit packaging is also of interest in terms of health economics. But the Afssaps’ arguments only applied to health establishments. However, Marisol Touraine wants unit conditioning to be tested in the city.
Unit delivery: a theoretical advantage
Parliamentarians have also very often looked into the issue of drug dispensing. Almost all health ministers have had their oral question from a senator or deputy on this issue. In 2011, Philippe Paul, UMP senator from Finistère, asked the Secretary of State for Health – in this case Nora Berra – “if the American model of delivering only the strict prescribed quantity has already been the subject of ‘a reflection for an adaptation to our country “and” to inform it of the measures taken by the Government to tend towards a packaging system allowing to achieve significant savings on our health expenses, to ensure the protection of the population and , quite simply, to avoid waste. “And clearly Nora Berra was not convinced since she replied that” the sale of drugs by the unit by dispensing pharmacists, so as to match exactly the quantities dispensed, could have the theoretical advantage of reducing the waste.
However, this interest can be balanced because the sale by the unit would require to guarantee the security of the identification of each unit and the conditions of conservation in the patients’ homes. The unitary packaging of pharmaceutical specialties could make it possible to meet these health safety requirements but would imply carrying out an in-depth and concerted reflection on the possibilities of its generalization which, moreover, does not prove or not very interesting in certain situations, in particular for chronic treatments. “And she concluded that in any case,” the possible implementation of the sale of single drugs would represent a cost that should be deducted from the savings potentially made due to less wastage of drugs. An economy is a sham if we believe the Secretary of State at the time.
What about health safety requirements?
In 2003, the same story goes for the Minister of Health at the time, Jean-François Mattéi. In response to a Socialist parliamentarian, he recalled that “the regulations prohibit, for reasons of health security, dispensing pharmacists from ‘unpacking’ presentations. In order to adjust the size of the presentations marketed to each type of treatment prescribed, it would therefore be necessary for the laboratory which produces the medicinal product to provide a very wide range of packaging. However, taking into account the costs which would result therefrom, in particular if the number of units sold for some of these packaging is low, the company risks wanting to pass on this additional cost in the selling price of all the presentations. Thus, it is not certain that the multiplication of packaging sizes is, in all cases, a source of savings for health insurance. “He therefore considered that” the opening of the possibility for the pharmacist to sell the patient of pharmaceutical specialties to the unit does not seem opportune. “
It seems, therefore, that for many years, opinions diverge on the question. The experiment launched by Marisol Touraine will perhaps allow everyone to agree, one way or the other.
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