Health insurance may soon no longer take care of 171 drugs and treatments sold in pharmacies.
A stomach ache, a slight finger cut, recurring insomnia … for many daily hassles of millions of French people go to pharmacy and buy drugs or antiseptics today very well known. Like many remedies sold in pharmacies in France, these drugs have the advantage of being, in part, reimbursed by health insurance. In the best of cases, some additional health mutuals can also reimburse part of the price of these purchases.
But until when will these drugs be reimbursed? The question has now arisen since the Minister of Health and Access to Care, Yannick Neuder, revived the debate on the reimbursement of certain drugs considered to have a “weak SMR”. Behind this acronym you have to understand: drugs with “low medical service rendered”. Currently reimbursed up to 15% by health insurance, the government therefore plans to definitively cancel the deframe of these drugs. He describes these “comfort drugs” treatments, believing that their therapeutic efficiency remains “very limited to the view of available scientific evidence”. And reimbursement at 15% of these drugs represents a cost of 600 million euros per year for health insurance.
As a reminder, the rate of management of medicines by social security depends on the SMR classification of each treatment. High and significant SMR drugs are reimbursed at 65% and 100%. This is the case, for example, of Doliprane. Moderate SMR drugs are reimbursed up to 30%, such as iModium or Voltarene. Finally, after low SMR drugs, there are insufficient SMR treatments which are simply not reimbursed. Among them there is in particular the biseptin antiseptic.
Thus, the government wants to switch 171 drugs in the low SMR category to the insufficient SMR category. This list of treatments is defined by the National Health Insurance Fund for salaried workers on the basis of assessments of the High Authority for Health (HAS).
Among the drugs concerned are well -known names for the general public: Gaviscon, used against gastric reflux, meteospasmyl for digestive disorders, or valium, an anxiolytic largely prescribed. Other daily products could also lose their partial reimbursement, including Dexeryl, a moisturizer for dry skin, betadine, reference disinfectant in many households, the zovirax against herpes, or the Noctran, prescribed for sleep disorders.
According to the Minister of Health, this reform would “concentrate efforts on high SMR treatments, reimbursed at 65 % or 100 %, where clinical gain is demonstrated”.
