• Mid-October, the free PCR and antigen tests will be over.

  • Only Covid-19 screening tests prescribed by a doctor will still be covered.

  • For analytical laboratories, where it has become the major activity since the start of the pandemic, this change should have an immediate economic and organizational impact.

    Just like for pharmacies, which carry out a large number of antigenic tests

No more what it costs and free testing for Covid-19. In mid-October, so-called comfort PCR and antigen tests will become chargeable. The objective: to encourage the last recalcitrant French to take the leap of vaccination, while the country should in the coming days pass the bar of 50 million first-time vaccinated. A strategy that attacks the wallets of the unvaccinated, who may then be more inclined to receive a free vaccine than to pay for a PCR or antigen test to benefit from a valid health pass.

For analytical laboratories as for pharmacies, which have carried out millions and millions of tests since the start of the pandemic, this measure should also have a significant economic impact.

How are they approaching this coming upheaval?

And how do they plan to use the lessons of this health crisis?

Fewer tests, therefore less revenue for laboratories

According to the Directorate of Research, Studies, Evaluation and Statistics (DREES), approximately 112.6 million tests were performed between March 1, 2020 and August 1, 2021, including 80 million PCR tests [including the price has varied since the start of the pandemic]. Or a total bill that would happily exceed 5 billion euros, entirely the responsibility of Social Security. For the government, there is no longer any question of maintaining these expenses. As of this fall, only people declared a contact case and those showing symptoms of the coronavirus and benefiting from a medical prescription will be able to be screened for free. For the others, the Vitale card will no longer be of any help, it will be necessary to extend the change: 43.89 euros for a PCR and 25 for an antigen.

Logically, this end of free access will lead to a drop in the volume of screenings. "Covid screening was an additional sector of activity for which we hired 12,000 people and invested in expensive equipment, in particular machines and reagents," said Dr. François Blanchecotte, president of the Union of biologists. But today, we expect a return to the situation before July 2020, when the government made the tests free. In practice, we expect an 80% drop in the volume of tests. We are therefore decelerating our orders for reagents, because it is difficult to see unvaccinated French people continuing to be screened every three days if it is at their expense ”.

It is therefore an entire economic section of this sector that could collapse.

“Job losses are to be feared, warns Dr. Blanchecotte.

All the people hired - nurses, engineers, couriers - to ensure the surplus activity of the last few months will not be able to be kept in post ”.

An effect also on the activity of pharmacies

And it's not just the laboratories that will be affected by this measure. The entry into force of the health pass in mid-summer generated a rush towards antigenic tests, popular with the unvaccinated thanks to their rapid results. For the week of August 9 to 15 alone, nearly 6 million tests were performed, more than two-thirds of which were by antigenic test, according to Drees. To meet the strong demand, barnums have sprouted like mushrooms all over France, in front of pharmacies, train stations and other busy places.

Among pharmacists - paid 25 euros per test - some have tried to make the most of this additional income by installing several barnums, sometimes far from their pharmacy.

"We were even seized for a Parisian pharmacy which set up a barnum in the south of France", indicates Pierre Beguerie, president of the central council of the Order of pharmacists.

But this good vein should dry up in the fall according to the same logic.

With paid tests, demand should fall, and the number of barnums mechanically drop, according to Philippe Besset, president of the Federation of Pharmaceutical Unions of France.

Less precise monitoring of the epidemic

So, will the end of support for tests make it harder to monitor the epidemic? "We have no response from the government on this point, but probably, this measure will make us blind: we will no longer have any idea of ​​the extent of the epidemic, fears Dr. Blanchecotte. The ARS could continue to conduct screening campaigns, but we are turning away from expert tests such as PCRs, no doubt in favor of antigenic tests or self-tests for the general public, and saliva tests in schools ”.

Will the high vaccination coverage in the country compensate for the less precise monitoring of the epidemic?

"I am not sure that it is important enough to eradicate the circulation of the virus," says Dr. Blanchecotte.

Especially since "the circulation of the Delta variant, which affects more young children, whose vaccination is not on the agenda, contaminations in the youngest should increase", abounds Dr. Jérôme Marty, general practitioner and president of the French Union for Free Medicine (UFML).

However, “today, we are asked to stop screening, that is to say the search for mutations.

Sequencing has largely been stopped, which makes it possible to monitor the appearance of new variants, continues Dr Blanchecotte.

And tomorrow, the tests will no longer be reimbursed, ”he insists.

Learn from the pandemic to renew yourself

But for laboratories as for pharmacies, there is no question of suffering this drop in income. "I think that prevention actions in pharmacies will develop for other types of pathologies," predicts Philippe Besset, assuring that it will probably be necessary to develop specialized spaces in pharmacies. Because now, it is a question of learning the lessons of the pandemic in order to renew oneself. "Laboratories have made a leap forward by equipping themselves for molecular biology, a technology used for PCR screening," says Dr. Blanchecotte. From now on, it is a question of the new screening tests being covered by the Health Insurance in molecular biology. Influenza and other viruses could be detected by PCR,which would allow us both to use the machines in which we have invested, but also to advance diagnostics in France, even if it means delisting certain obsolete tests in favor of these future techniques. Imagine that they are also deployed within hospitals, this would make it possible to obtain diagnoses in less than an hour on viruses, bacteria and fungi, and to save precious time in the care of patients ”.and to save precious time in the care of patients ”.and to save precious time in the care of patients ”.

And in the laboratories, in addition to preparing the world after, we are also slowly coming back to the world before.

“After long months of operating 24/7, recalls Dr Blanchecotte, we are starting to find a less athletic pace, which allows us to return to our core business: the biology of chronic disease monitoring, which could have been less closely monitored at the height of the epidemic waves, and for which it is time to make up for the delay ”.

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