Health insurance will not come back to its decision.
About 80 euros per box. Thousands of French people go to pharmacy every week for this medication. Without him, their whole organism is deregulated. Increase in blood sugar, cardiovascular complications, weight gain … They cannot do without it. But health insurance hardens its reimbursement conditions from September 1, due to misuse exposing to serious effects.
This medication is part of the family of GLP-1 analogues, a natural hormone that plays a key role in the regulation of blood sugar. Authorized only for diabetic people, it also interests all those who wish to lose weight. As it reduces appetite and satiates quickly, it makes you lose weight. Weight loss can go up to 3 to 5 kg in 6 months to 1 year. Problem: this “slimming” effect is not a reason for prescription recognized by the French health authorities. Doctors are not allowed to prescribe it in this indication. However, Health Insurance and the National Medicines Agency (ANSM) note that part of the prescriptions is made to lose weight.
To counter this phenomenon and guarantee the availability of drugs to patients who need it, the CNAM established a compulsory form in early 2025, to be given to the patient with the prescription to justify that the prescription respects the AMM (marketing authorization) and allow reimbursement. Since June 1, the reimbursement is no longer possible without proof presented to the pharmacist. Health insurance, however, tolerated an a posteriori refund afterwards, until August 31. September 1, it will be over: “Proof will be essential for the care of the drug and no a posteriori refund will be made “ warns the CNAM. The drug is the semaglutide better known as Ozempic®. This system also concerns antidiabetics TRULICITY® (DULAGLUTIDE), Victoza® (LIRAGLUTIDE) and Byetta® (Exenatide).
As the ANSM recalls, around 700,000 diabetic patients are treated with these treatments. If the doctor prescribes them out of AMM, he will wear the “non -refundable” or “NR” mentions on the prescription and will inform the patient that the treatment will not be reimbursed. The similar drugs of GLP-1 authorized in the treatment of obesity such as Wegovy® (semaglutide), Mounjaro® (shooting) and Saxenda® (liraglutide), are not affected by this form since they are not reimbursed. They are only available on prescription and at the patient’s costs, which must pay around 300 euros per box.
