INTERVIEW – After months of negotiations with the Health Insurance, pharmacists obtained financial guarantees for the transition of their mode of remuneration.
The final point of negotiations on the new pharmacists’ agreement was eagerly awaited, after more than five months of discussion. It had to act on the desire for development of the profession, in particular on the side of dispensing pharmacists, whose practice depends too much on the distribution of boxes of drugs.
Pharmacists demanded remuneration for the act of dispensing, that is to say the association of the dispensing of drugs with the preparation, and the role of advice. The commercial margin on the sale, which represents half of the remuneration of pharmacists, will eventually be eliminated. The negotiations were an opportunity to foresee this transition.
And, already in April, the different parties had agreed on the evolution for 2018. It was on the volume of the envelope proposed by the government to support this transition that the disagreements focused.
The two pharmacists’ unions represented in the negotiations, the USPO (1) and the FSPF (2), asked for 300 million euros, while they were only offered 250. Finally, the two parties agreed on a sum of 280 million euros. Gilles Bonnefond, President of the USPO, explains the usefulness of this funding to Why actor.
What motivated the pharmacists’ claims?
Gilles Bonnefond: The whole strategy of the public authorities today is based on the search for savings on drugs. But a drop in price means a drop in the margin for pharmacists. Now we want more prescription fees, specific fees for drugs that require special attention, for prescriptions that affect the elderly, or very young patients.
This development has already started, some fifteen years ago. It is slow, but this fee-for-service already exists with pharmaceutical interviews to support patients on oral anticoagulants or asthma.
(1) Union of Unions of dispensary pharmacists
(2) Federation of community pharmacists
What will the new convention change?
Gilles Bonnefond: The agreement will record this modification of the pharmacist’s mode of remuneration. Today, it depends on the commercial margin, and we want it to be more focused on the profession of pharmacist, and its role in supporting fragile, elderly and chronic patients. It is a repositioning of the profession of pharmacists, which will no longer be a distributor of boxes, but a health professional. The USPO unanimously voted on the project and the FSPF decided not to sign it. This is enough to validate it, the two unions each representing more than 30% of the profession.
What will the envelope be used for?
Gilles Bonnefond: In a context of falling prices, we want to secure the remuneration of pharmacists, so that this reform is implemented without putting pharmacists at risk. We take the profit margin, and we turn it into fees. And this transition leaves 50% of pharmacists at a loss, while 50% will gain.
It’s not possible, and that’s why we need this investment. Not to revalue, but really to put the reform in place. The acts to the ordinance will generate an additional cost of 70 million euros per year. To which are added other remuneration items such as custody fees or indemnities for the paying agent. The investment of 280 million over three years seems to me to be the minimum acceptable for the success of this reform.
.
