Prescription Charges in France

Prescription Charges in France

Background

The French have a system of statutory heath insurance which has almost universal coverage. In addition, 90% of the population belong to supplementary sickness or private insurance [2] schemes. Most of the French health care expenditure is financed through employee and employer contributions (75%). The rest comes from patient payments and private insurance.

Under the French system, to gain reimbursement a medication must be registered on lists of approved medication [2].

Patient co-payments

French patients have to pay a percentage of the cost of their prescription medication up to the reference price for that drug, plus any cost above that up to the dispensing price (see below). Co-payments in France depend on the seriousness of the disease and the benefit the French government has assessed that the medication has. The majority of people in France cover the difference between their co-payment and the reference price through private and other insurances. This does not however tend to cover the cost above the reference price.

Contribution (serious disease)

French co-payments per year as of 2005[1]:

  • Major Benefit: 35%
  • Moderate Benefit: 35%
  • Modest Benefit: 65%
  • Insufficient Benefit: 65%

Contribution (non-serious disease)

French co-payments per year as of 2005[1]:

  • Major Benefit: 65%
  • Moderate Benefit: 65%
  • Modest Benefit: 65%
  • Insufficient Benefit: 100%

Reduced Co-Payments

As can be seen above, co-payments are less for serious diseases where the drug being used is seen as having major or moderate benefit to the patient.

Co-Payment Exemptions

Co-payment exemptions are available for a list of 30 serious diseases; disabled patients; expectant mothers in the last four months of pregnancy; the unemployed; those on low incomes; and for the treatment of other chronic conditions and those needing multiple therapies on a named patient basis [1].

Cap on Co-Payment

There is no general cap on co-payments in France.

Resources

Notes

    1. Bronner, M et al (2005) Pharmaceutical Pricing & Reimbursement 2005: a concise guide, PPR Communications Ltd.
    2. Seget, S (2005) Pharmaceutical Pricing Strategies: price optimisation, reimbursement and regulation in Europe, US and Japan, Business Insights Ltd.

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