Their reimbursement should drop from 100% to only 15%.
The measurement is not yet ratified but it should be controversial. According to a decree on the way to being signed, the drugs whose medical service rendered (SMR) is deemed “weak” by the High Authority for Health (HAS) should no longer be completely reimbursed for certain insured people from February 1, 2026. And there are many …
Gaviscon®, Spasfon®, MeteospasMyl®, Dexeryl®, Betadine® … Names of drugs that all French people know because they are part of the therapeutic arsenal of everyday life. A stomach ache, heartburn … and these treatments stand out from the pharmacy cabinet. The problem is that their management costs (too much) dear to health insurance in a period when making savings is more than ever of rigor. So how to do it? For the General Inspectorate of Social Affairs (IGAS) and the General Inspectorate of Finance (IGF), it’s simple, it is less necessary to reimburse them. This is already the case for the majority of French people who pay the purchase of these drugs up to 85% and is only reimbursed 15% (upon presentation of a prescription). But not for everyone. Currently, 14 million French people are reimbursed 100% when they are issued these treatments. An advantage which should disappear on February 1, 2026, according to information from the Parisian.
These insureds have a maximum refund because they are recognized in ALD or “long -term affection”. However, a decree awaiting signature provides “An abolition of the exemption from the participation of the insured in long -term affection for the relative costs (…) to medicines with medical service rendered low”. Once the decree has been signed, they will only be reimbursed 15% like the rest of the French insured. You should not count on complementary health because, except specific option, they do not support the reimbursement of poor SMR drugs. The prices of these treatments oscillate between 2 and 6 euros.
While health insurance seeks to make 5.5 billion savings next year, the abolition of the moderating ticket on low SMR medicines should save 90 million euros per year, according to the calculation of IGAS and IGF indicated in the “Expenditure review for long -term conditions” of June 2024. To this measure should be added the drop in the reimbursement in thermal cures from 100% to 65% to 65% The insured in ALD. A saving of 25 million euros for health insurance. It remains to be seen whether the decree will indeed be signed, and how it will be welcomed by the millions of patients concerned.
