[Access to medicines in France]

In France the total cost of medicinal products reimbursed by health insurers in 2007 was over 25 thousand million euros, and access to new drugs is neither restricted nor rationed, despite the unfavorable economic situation. In 2007 and 2008 the Transparency Commission (TC) of the French National Authority for Health (Haute Autorité de Santé) approved the reimbursement of 97% of new drugs and new indications for existing products, within 90 days on average. The 3% of medicinal products that were not approved did not represent therapeutic advances and could be considered to be of dubious utility. If evaluation of new drugs is to be an independent process, then HAS must not only be independent of the decision-maker, funding bodies and commercial firms, but must also be a purely medical and technical organization. This implies removing all financial consideration from the picture, including the size of the target population that may qualify for a new treatment. This system could be further improved by creating special procedures to promote funding for innovations outside the marketing authorization system, thereby providing patients with faster access to the drugs they need; these procedures would include temporary authorisation, temporary treatment protocols, and a special-case function for treatment of chronic and rare conditions. Currently, new treatments produced by the pharmaceutical industry are paid for by national funding bodies and, from this point of view, it is difficult to argue that drug innovation is under-supported in France. On the other hand, it is well known that France has long been the largest consumer of medicinal drugs, both in Europe and worldwide. Two behavioral patterns partially explain this situation: one is a tendency to believe that drugs are the answer to all health concerns, and the other is a preference for new, more expensive drugs, even though "never" is not necessarily "better".