The Minister of health Xavier Bertrand caution a bad memory

The record of the reimbursement of less effective drugs re-emerges. In 1999, Martine Aubry, then Minister of employment and solidarity, had initiated the process by evaluating medical service (SMR) of all drugs. For a little more than 800 of them, the SMR was considered "inadequate", but the Jospin Government had not responded. Then, Jean-François Mattei had decided to remove their refund in three waves. A first hit 82 products found to be less effective in the summer 2003, little widespread drugs is concerned. The second resulted in the decrease to 1 February, 35 to 15 of the rate of reimbursement of 62 veinotoniques (heavy legs) and, on 1 March, the total reimbursement of 156 drug: expectorants, products based on plants, antidiarrheals, etc. This should allow Medicare to save approximately EUR 450 million full-year. The Minister of health Xavier Bertrand caution a bad memory. It was little appreciated to see the high authority for health (HAS) put at the foot of the wall in presenting a very severe notice, and without appeal, on these drugs. Veinotoniques remaining very popular the Daflon was the 9th most prescribed drug in 2005 to 11.8 million boxes ( 4) and with few alternatives, the Government had finally opted for the creation of this new transitional rebate of 15 rate, before a reimbursement total planned for 2008.

Xavier Bertrand will have fewer problems with the third wave, which was to be 143 medicines, essentially vasodilators (cardiovascular diseases) and treatments for disorders of the memory (nootropic), as well as a few antidiarrheals, anti-infective and treatments Ent. They have all been reviewed, in recent weeks, by the commission of the transparency of the high authority, which completes its work this week. Unlike the two previous waves, these drugs are all compulsory prescription. However, according to our information, the transparency commission should estimate that for about half of the grounds for limitation current, vasodilators have sufficient value to justify their refund. The issue is of importance to the industrial, because 143 drugs represent some 400 million euros of turnover, 80 per cent from the vasodilators and nootropic, and 250 million euros of expenses for reimbursement for social security.

Good use agreements

Of course, the high authority, which will then make a recommendation to the Government, should emphasize the need to limit the support of vasodilators to pathologies for which the RSM is considered sufficient. The margins are considerable: a study of the Irdes (Institute for research and documentation in health economics) has recently shown that in France consumption was two times higher than in Germany, and seventeen times higher than in Britain! But, in fine, vasodilators will be not be deleted from the list of refundable drugs, measure Cleaver which often means the death of a product. And health insurance is not able to control the correctness requirements, sales are likely to maintain a high level. The high authority should, however, recommend to the CNAM to agreements of good use of care with physicians, in order to avoid the non-justified requirements. And if reimbursement expenses did not fall, the Government can then impose cuts of tariffs on industrial. But one thing is already certain: from economies of the third wave will be low.