Non-reimbursable drug sales plummet in France

New data published by the France's Institute of Health Economics Research and Documentation (IRDES) has revealed a 50% drop in the prescribing of drugs during 2006 which were removed from the reimbursement list by the government's high health authority (HAS; Marketletters passim). However, savings have been slow to appear in the reimbursable sector or have simply not been achieved.

The percentage of physician visits resulting in expectorant and mucolytic product prescribing declined from 34% in February 2006 to 17% the following month after the delisting of these agents from March 1, 2006. The downturn was also especially notable among varicose vein treatments, which were subjected to three phases of "de-reimbursement" - in 2004, 2006 and 2007. From January 1 this year, the entire category is delisted after being assessed as offering little medical benefit relative to its cost. However, after the 2006 operation which saw reimbursement cut from 35% to 15%, self-medication sales of these medicines grew by one third in value. By volume these dropped to 74.7 million packs in 2006, a 20% decline, but stabilized in 2007.

Another example of a marked fall in prescribing following de-reimbursement has been in the area of acute or chronic bronchitis. Previously, 59.5% of consultations were followed by a prescription, falling to 30.5% after the policy change. Despite this marked decline, the IRDES report notes that, depending on diagnosis, medical practitioners have tended to be slow to reduce prescribing in other therapeutic categories including brochodilators, some non-steroidal anti-inflammatories and corticoids though the "medical justification for this is not always easy to establish." The survey also found that the decline in prescribing occurred regardless of the age or gender of patients or doctors but was related to doctors' surgery activity levels, although regional variations were also identified by researchers.