TY - JOUR
T1 - Ongoing pharmaceutical reforms in France
T2 - Implications for key stakeholder groups
AU - Sermet, Catherine
AU - Andrieu, Veronique
AU - Godman, Brian
AU - Van Ganse, Eric
AU - Haycox, Alan
AU - Reynier, Jean Pierre
PY - 2010
Y1 - 2010
N2 - 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 anxiolytichypnotic 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 27millionyear by decreasing antibacterial prescribing, €450million/year by not reimbursing ineffective drugs, €670million/year from pharmaceutical company rebates and approximately €1 billionyear from increased prescribing and dispensing of generics (year 2003-7 values). Additional savings of at least €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.
AB - 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 anxiolytichypnotic 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 27millionyear by decreasing antibacterial prescribing, €450million/year by not reimbursing ineffective drugs, €670million/year from pharmaceutical company rebates and approximately €1 billionyear from increased prescribing and dispensing of generics (year 2003-7 values). Additional savings of at least €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.
UR - http://www.scopus.com/inward/record.url?scp=74249104458&partnerID=8YFLogxK
U2 - 10.2165/11313900-000000000-00000
DO - 10.2165/11313900-000000000-00000
M3 - Comment/debate
C2 - 20038190
AN - SCOPUS:74249104458
SN - 1175-5652
VL - 8
SP - 7
EP - 24
JO - Applied Health Economics and Health Policy
JF - Applied Health Economics and Health Policy
IS - 1
ER -