Prescription medicines in France: how reimbursement and mutuelle top-ups work

In France, reimbursement for medicines ranges from 15% to 100% of the cost, depending on their medical effectiveness and importance. 

Reimbursement is only available for prescribed medicines and patients do not need to pay upfront for state reimbursed costs, as these payments are made directly to the pharmacist.

If you are now resident in France and part of the healthcare system, you will need to present your carte Vitale (health insurance card) and mutuelle card (top-up health insurance) if you have one to the pharmacist when collecting medicines. 

Depending on your policy, your mutuelle may cover any remaining costs after the state reimbursement or else you will need to pay for the remainder yourself. 

Reimbursement rates for medicines

Medicines are reimbursed based on their medical effectiveness, with different reimbursement rates:

• 100% reimbursement: For essential medicines used to treat very serious illnesses.

• 65% reimbursement: For medicines with significant effectiveness. There are proposals to reduce this to 60%.

• 30% reimbursement: For medicines with moderate effectiveness, including some préparations magistrales (medicines specially made by the pharmacist). Proposed to become 25%.

• 15% reimbursement: For medicines considered to have a weak medical effect.

Certain other remedies, that may still in some cases be recommended by doctors as having a likely therapeutic benefit, are not state-reimbursed at all.

When a medicine is reimbursable, the pharmacist will print a ticket Vitale on the back of the original prescription to show the reimbursement level. You can also scan a code on the box using a smartphone application, medicaments.gouv.fr.

As new medicines enter the market, older drugs may lose their reimbursement status or have the reimbursement rate reduced by the Ministry of Health.

How to reduce costs for long-term medicines

If you require long-term medication, it may be worth opting for larger pack sizes to minimise additional costs. 

This can help to reduce franchise payments which are a small amount taken off the reimbursement given per box.

Additional pharmacist fees

Pharmacists are authorised to charge a small fee for their services, known as honoraires de dispensation. 

This fee will be printed on the ticket Vitale and covers the pharmacist’s work in analysing the prescription, providing advice, or adapting the amount of medicine to your needs. 

This additional charge can vary based on the complexity of the prescription and the size of the medicine pack. 

These fees are reimbursed by the state to the same level as the medicine, with any remaining amount typically covered by the mutuelle.

Accessing information on medicines

You can check the price of some medicines by entering details at Service-Public.fr.

You can also find detailed information on specific medicines, including pricing, reimbursement rates, and available formats by searching the public medicine database.

Compassionate access for experimental medicines

In some cases, experimental medicines or treatments for rare diseases that are not yet available or reimbursed in France could be granted through a ‘compassionate access’ protocol. 

Where given, this allows patients or specific groups to receive treatment before normal market approval.