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Ongoing Pharmaceutical Reforms in France: Implications for Key Stakeholder Groups


Author Info

  • Catherine Sermet

    (IRDES (Institut de recherche et de documentation en conomie de la sant), Paris, France)

  • Veronique Andrieu

    (Pharmacie Galnique Industrielle et Cosmtologie, Universit de la Mditerrane, Marseille, France)

  • Brian Godman

    (Institute for Pharmacological Research ‘Mario Negri’, Milan, Italy; University of Liverpool Management School, Liverpool, UK; Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden)

  • Eric Van Ganse

    (Pharmacoepidemiology Unit, Centre Hospitalier Universitaire-Lyon, Lyon, France)

  • Alan Haycox

    (University of Liverpool Management School, Liverpool, UK)

  • Jean-Pierre Reynier

    (Pharmacie Galnique Industrielle et Cosmtologie, Universit de la Mditerrane, Marseille, France)


The rapid rise in pharmaceutical costs in France has been driven by new technologies and the growing prevalence of chronic diseases as well as considerable prescribing freedom and choice of physician among patients. This has led to the introduction of a number of reforms and initiatives in an attempt to moderate expenditure whilst ensuring universal coverage and rewarding innovation. These reforms include accelerating access to and granting average European prices for new innovative drugs, delisting drugs where there are concerns over their value and instigating rebates for excessive prescribing. Alongside this, ongoing initiatives to improve the quality and efficiency of prescribing include programmes to enhance generic prescribing and dispensing as well as to reduce antibacterial and anxiolytic/hypnotic prescribing. However, there have been few publications documenting the impact of specific reforms on the overall costs and quality of care, which have been exacerbated by compartmentalization of budgets. Estimates suggest savings of over &U20AC;27 million/year by decreasing antibacterial prescribing, &U20AC;450 million/year by not reimbursing ineffective drugs, &U20AC;670 million/year from pharmaceutical company rebates and approximately &U20AC;1 billion/year from increased prescribing and dispensing of generics (year 2003-7 values). Additional savings of at least &U20AC;1.5 billion/year are seen as being possible from increased use of generics such as generic proton pump inhibitors, statins (HMG-CoA reductase inhibitors) and ACE inhibitors instead of current branded products such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]). Delisting drugs when there are concerns about their value provides an example to other countries with currently limited demand-side measures. Other possible examples include price : volume agreements and multifaceted campaigns to enhance generic prescribing and dispensing and reduce antibacterial prescribing. Possible future initiatives could include adopting more stringent criteria for categorizing new drugs as innovative as well as further reductions in the prices of generics. Other initiatives could include further enhancement of the quality and efficiency of prescribing, including formal auditing of physician prescribing, as well as increasing efforts to monitor the risk : benefit ratio of new drugs post-launch in real-world practice.

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Bibliographic Info

Article provided by Springer Healthcare | Adis in its journal Applied Health Economics & Health Policy.

Volume (Year): 8 (2010)
Issue (Month): 1 ()
Pages: 7-24

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Handle: RePEc:wkh:aheahp:v:8:y:2010:i:1:p:7-24

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Keywords: Health-policy;

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Cited by:
  1. Brian Godman & Marie Persson & Jamilette Miranda & Peter Skiöld & Björn Wettermark & Corrado Barbui & Lars Gustafsson, 2013. "Changes in the Utilization of Venlafaxine after the Introduction of Generics in Sweden," Applied Health Economics and Health Policy, Springer, vol. 11(4), pages 383-393, August.
  2. Rajan Ragupathy & Katri Aaltonen & June Tordoff & Pauline Norris & David Reith, 2012. "A 3-Dimensional View of Access to Licensed and Subsidized Medicines under Single-Payer Systems in the US, the UK, Australia and New Zealand," PharmacoEconomics, Springer, vol. 30(11), pages 1051-1065, November.
  3. Ana Caires de Souza & Francisco de Acurcio & Augusto Guerra Júnior & Renata Rezende Macedo do Nascimento & Brian Godman & Leonardo Diniz, 2014. "Insulin Glargine in a Brazilian State: Should the Government Disinvest? An Assessment Based on a Systematic Review," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 19-32, February.
  4. Sandmann, Frank G. & Franken, Margreet G. & Steenhoek, Adri & Koopmanschap, Marc A., 2013. "Do reassessments reduce the uncertainty of decision making? Reviewing reimbursement reports and economic evaluations of three expensive drugs over time," Health Policy, Elsevier, vol. 112(3), pages 285-296.
  5. Sylvain Pichetti & Catherine Sermet & Brian Godman & Stephen Campbell & Lars Gustafsson, 2013. "Multilevel Analysis of the Influence of Patients’ and General Practitioners’ Characteristics on Patented Versus Multiple-Sourced Statin Prescribing in France," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 205-218, June.
  6. Ulrik Hesse & Brian Godman & Max Petzold & Andrew Martin & Rickard Malmström, 2013. "Impact of Delisting ARBs, Apart from Losartan, on ARB Utilisation Patterns in Denmark: Implications for Other Countries," Applied Health Economics and Health Policy, Springer, vol. 11(6), pages 677-685, December.
  7. Pieter Dylst & Steven Simoens, 2011. "Does the Market Share of Generic Medicines Influence the Price Level?," PharmacoEconomics, Springer, vol. 29(10), pages 875-882, October.
  8. Pieter Dylst & Arnold Vulto & Brian Godman & Steven Simoens, 2013. "Generic Medicines: Solutions for a Sustainable Drug Market?," Applied Health Economics and Health Policy, Springer, vol. 11(5), pages 437-443, October.
  9. Brian Godman & Lars Gustafsson, 2013. "A New Reimbursement System for Innovative Pharmaceuticals Combining Value-Based and Free Market Pricing," Applied Health Economics and Health Policy, Springer, vol. 11(1), pages 79-82, February.
  10. Magda Wladysiuk & Aleksander Araszkiewicz & Brian Godman & Katarzyna Szabert & Corrado Barbui & Alan Haycox, 2011. "Influence of patient co-payments on atypical antipsychotic choice in Poland," Applied Health Economics and Health Policy, Springer, vol. 9(2), pages 101-110, March.


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