A lesser effort than expected requested from complementary health insurance and patients, but an effort all the same: the Minister of Health Geneviève Darrieussecq presented Monday, at the opening of the debates on the Social Security financing bill for 2025 at Senate, the government’s new budgetary equation to respond to the slippage in health spending. Without obtaining the satisfaction of either users, mutual insurance companies, or the pharmaceutical industry.
Medical consultations will be reimbursed in the future at 65% instead of 70%. The government’s initial project planned to reduce their health insurance coverage to 60%. For the 96% of patients who benefit from complementary health insurance, this covers the rest of the consultation with the exception of the “deductible” (two euros for each consultation). The drug will also be used: the three existing reimbursement rates (65%, 30% and 15%) will a priori be lowered in the same proportion, by 5 points each. The amount of the transfer of charges to complementary funds was thus reduced “from 1.1 billion to 900 million euros”, specified the minister.
Dissatisfaction of mutual insurance companies and patients
The supplementaries had already warned that these transfers would result in an increase in the contributions requested from policyholders. These transfers will threaten “the economic balance of an entire sector” and “weigh above all on the elderly”, who are heavy consumers of medicines, criticizes the Fédération de la Mutualité française in a press release.
Supplementary health insurance will “automatically increase their contributions and at the end it is health users who will pay”, also deplored Monday on franceinfo Gérard Raymond, president of France Assos Santé. “Those who are disadvantaged, who do not have additional insurance, will receive much less care,” he also regretted. Consequence according to him, a saving measure which will not even be effective: “We are not going to make any savings […] because we are going to worsen the state of health of the entire population.”
Pharmaceutical laboratories angry too
To achieve a savings objective of “up to 5 billion euros” on health spending, the executive is also considering “cuts in the price of health products for 1.2 billion euros”, as well as ” efficiency measures at the hospital” for 600 million and also on city care for 600 million, the minister also said.
Furthermore, Geneviève Darrieusecq confirmed a “skid” in drug spending this year, “estimated at 1.2 billion euros”, which the government intends to limit after a “dialogue with manufacturers in order to find compensation mechanisms” . This deviation from forecasts is attributed to discounts from manufacturers that are smaller than expected. Discounts allow you to pay less for medicines than the official price. At the end of the year, the laboratories then remit to the State the difference between the official price and the negotiated price.
The financial contribution of pharmaceutical laboratories, via the sector’s “safeguard clause”, would only be “activated in the event of failure of the approach”, added the minister. Each year the social security financing law (LFSS) sets an envelope for reimbursable medicines. If sales exceed this ceiling, a mechanism called a safeguard clause applies and the laboratories must repay approximately 70% of the overpayment to Health Insurance.
“While public finances are undergoing a critical deterioration, the State is once again targeting, in alarming haste, the pharmaceutical sector, already subject to one of the heaviest taxes in Europe,” protests the union. of the pharmaceutical companies (Leem) in a press release. “The government is asking the Senate to examine a text modified at the last minute on the basis of quantified hypotheses which have not been evaluated,” deplores Leem, which appeals to the Senate “to reject” “incoherent and destructive” for the sector.
The pharmaceutical industry lobby assures that its “monitoring tools do not foresee any slippage of this order” and that the “hasty and unjustified revisions” serve, according to it, “above all as a justification for coercive measures”.