Budget 2023: confrontation in sight between drug manufacturers and the State

The drugmakers make a face. The Government asks them for an economic effort of almost 1,000 million euros within the framework of the Social Security Financing Bill (PLFSS) presented this Monday. Which rankles stakeholders for whom these requirements run counter to recent promises of support for the health industry.

This project “turns its back on innovation, sounds like death to France’s industrial ambitions and, ultimately, threatens the French’s access to their medicines,” says Thierry Hulot, president of LEEM, the umbrella organization for companies in the pharmaceutical sector in France. The spokesman is also president and CEO in France of the Merck laboratory.

The executive argues “the very strong dynamics of the medical device market” to justify the “efficiency effort of 1,100 million euros” requested from this industry.

“reasonable” effort

The Government’s challenge is to control health spending, which promises to remain very dynamic (with a goal of increasing spending by 3.7% next year) while Social Security accounts, still in marked improvement, remain in the red.

In detail, the Government intends to negotiate 900 million euros in price reductions for the reimbursement of medical devices. It also plans to recover 200 million euros under the “safeguard clause”. This is the contribution due by manufacturers when the turnover in France of certain medicines exceeds a certain threshold.

The effort required is “reasonable compared to what has been done in previous years,” they say in Bercy. “This is comparable to a dynamic of spending on health products that increases by 6% per year.” And the executive argues that in 2018 the amount of savings requested was 1,500 million euros.

Commitments “fulfilled”

According to the government, the Social Security budget project also respects the promises of public support to the health industry made during the previous five years to learn the lessons of the Covid crisis. Supposedly to make France “an innovative and sovereign European nation in health,” they planned to increase reimbursements for health products by 2.4% per year.

These commitments “will be respected and even beyond, with growth that will exceed +2.4%”, says the executive. It was not enough to reassure drugmakers who had nonetheless welcomed the commitments to support the sector made during the Health Industries Strategic Council in the summer of 2021.

Pharmaceutical companies fear that the starting point from which the State will judge the evolution of drug reimbursements is too low and disconnected from the reality of the very dynamic market. Result: Ultimately, they should return much more money to the state than was announced today.

Improve the relevancy of recipes

The Social Security budget project also wants to propose “new regulatory tools” to guarantee the “expenditure sustainability” of medical devices that do not attract manufacturers much more. According to our information, the LEEM will meet on Tuesday to organize its response before the debates in Parliament.

To control drug spending, the government also counts, as every year, on actions by the National Health Insurance Fund that would improve the relevance of prescriptions. These “medicalized control actions” would allow the release of 750 million euros in 2023. The executive also expects to save 180 million euros thanks to the fight against fraud.

Laboratories are not the only private companies affected by the search for savings for Medicare. The Government also wants to involve the medical biology sector (250 million euros) and the medical imaging sector (150 million).