The High Authority for Health (HAS) regularly assesses the clinical interest of drugs. When the medical service rendered (SMR) is considered low, reimbursement drops to only 15 %. So far, long -lasting patients (ALD) have escaped this rule and continued to be reimbursed 100 %. But that should end, next February.
What is a long-term condition (ALD)?
A long -term condition is a chronic or serious disease requiring prolonged treatment (diabetes, cancer, multiple sclerosis, etc.).
In the event of an exemption, care related to the disease is reimbursed 100 % on the basis of social security.
In non -exempt ALD, care is reimbursed at the usual rates, but open up to certain advantages such as prolonged sickness.
What drugs are concerned?
Among the products concerned are common drugs, such as Gavisconused against gastroesophageal reflux or Spasfonprescribed for digestive disorders.
In total, more than a hundred drugs will no longer be fully taken care of, for these patients.
From 100 % to 15 %: one remains for 14 million patients
In France, nearly 14 million people are in ALD. For them, the reimbursement of these drugs will therefore go from 100 % to 15 %. A problem for some patients whose complementary health will not support the difference.
If the government sets up this type of measure, it is simply to pursue its objective: to save money.
According to an IGAS and IGF report, the abolition of this exemption would reduce social security expenditure by around 90 million euros per year.
The same decree also provides for another measure: thermal cures for ALD patients will no longer be reimbursed at 100 %, but at 65 %, as for the other insured. This change should generate 25 million euros in additional savings.