Pharmacy punished

The tiers-payant is the system whereby patients do not need to advance the reimbursed part of the drug’s cost (often all of it if they have a top-up mutuelle).

A generic is a non-branded product with the same active ingredients as a branded one (though the precise composition may not be identical to the original). The French terms for the two are a générique and the princeps.

The government wants people to use more generics because they are cheaper so the cost of reimbursement is reduced.

The manager of the pharmacy involved says she plans to appeal and told journalists: “As far as I know we’re the first that this has happened to. I think they wanted to make an example of us.”

She said the Cpam told her in 2011 to aim for 60%.

She said she tried but many local doctors write on prescriptions that the medicines are “non-substitutable”.

She added that she was not against generics if they are good quality, but added “they’ve pretty much ‘genericed’ everything, any old thing, and we’ve noticed problems.”

Under the latest rules, patients who refuse generics are refused the tiers payant. In some departments this is reportedly even the case where a doctor has written on the prescription that the drug is non-substitutable.

The Académie Nationale de Médecine confirmed earlier this year in a report that generics can vary from the princeps in some minor ingredients.

It added that they may sometimes cause allergic reactions because of these differences or confuse elderly patients with long-term health problems if they are asked to change.