Branded medicines now only reimbursed at generic price

Patients in France who refuse generic versions of their medication will now be reimbursed less, under new rules that came into force on January 1, which are expected to save the State €100 million per year.

7 January 2020
By Connexion journalist

Now, medicines will be reimbursed at the price of their generic version, where one is available, the decree from November 12, 2019 said. Generally, generic versions of medicines cost on average 30-40% less than their branded counterparts.

The rest of the cost for the branded medication will be paid by the patient, if they refuse to take the generic version. So far, there are only three exceptions.

The measure is expected to save the Sécurité Sociale more than €100 million per year.

The move is part of a new set of laws aiming to encourage the use of generic medicines. Currently, the rate of generic medicine use in France is at 80% but the government is aiming to maintain and improve this, as “current substitution systems appear to be running out of steam”.

Until now, doctors have already been encouraged to offer generic medicines, except where specified on the prescription by a “non substituable" (non-substitutable) ou "NS" note. This allowed patients to receive the medicine brand that they were used to, without extra medical justification, or paying more.

This will no longer be the case, apart from with three exceptions including certain drugs with “a narrow therapeutic margin”, including thyroid illness medicine Levothyrox (and its active ingredient, levothyroxine), which has been the subject of controversy, legal battles and even manslaughter charges in recent years after many thousands of patients claimed that one “new formula” did not work.

Another exception is for medicines for children under the age of six where the medicine is not available in such a suitable format in a generic version. 

Finally branded versions will be permitted and reimbursed in full if patients are allergic to certain elements found in the generic version (but not in the branded one).

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