France's drug spending up 1.4% says CNAM

Spending on drug products by the French health service rose only 1.4% in 2006 with the increase in spending on reimbursable products only 0.4%, according to final figures released by the French national sickness insurance fund (CNAM). Low growth in drug spending was recorded because generic substitution achieved a level of over 70%; there were key reductions in prices affecting drug products older than five years; a number of drugs were removed from the list of reimbursables in March 2006; and the prescribing of certain drug categories (antibiotics, statins and psycholeptics) was tightly controlled. The CNAM findings are broadly consistent with those of the French drug industry association (LEEM) which reported earlier this month (Marketletter June 18).

The volume of drug packs reimbursed in 2006 fell 1.2% last year but the drop was as much as 6.1% if products that were removed from reimbursement lists were included. The fall was especially sharp in the case of psycholeptics (109 million packs in 2006 against 122 million in 2005) and antibiotics (86 million against 90 million). On the prices front, the overall decline was about 3.1%.

However, the figures also indicate that spending has continued to rise because of the renewed emphasis on newer and costlier drug products. This structural effect led to a rise of 6.5% in 2006 and the CNAM noted that the cost of new drugs launched on the market was particularly high. Many of these drugs are used to treat chronic conditions and are often fully reimbursed. Examples include Swiss drug major Novartis' leukemia drug Glivec (imatinib) with a reimbursement cost of about 111.0 million euros ($146.8 million) for the treatment of about 3,000 patients. Plavix (clopidogrel), marketed in France by local drug major Sanofi-Aventis, headed the costs league with growth of 12.4% to 401.0 million euros.