The Social Security financing bill (PLFSS) for 2023, much criticized by the pharmaceutical industry, is tackling the subject.

Because medicine has experienced technological leaps - expensive - for a decade.

And the diagnostic sector is not left out, explains to AFP Pascal Pujol, head of the oncogenetics department of the Montpellier University Hospital.

"Let's take the example of rare diseases, which many deficient genes can explain. Genomics (or genome science, editor's note) makes it possible to provide precision in their diagnosis and their management", he develops.

But these promises for patients come at a stratospheric cost.

Thus, for Zolgensma, a gene therapy for a rare disease from the Swiss laboratory Novartis, it takes some 2 million euros per patient.

"The question of taking charge of innovations arises for all countries, because budgets are not extensible, including in Western Europe", underlines Alexandre Regniault, lawyer and head of the health and life sciences division. for Simmons & Simmons.

"As always when we have important innovations, the prices are very high", abounds the health economist Bruno Ventelou, director of research at the CNRS.

In 20 years, as production techniques improve, the prices charged by laboratories should be more reasonable, he says.

Reimbursement based on performance

Faced with the explosion of costs, the PLFSS 2023 proposes "an innovative financing model for innovative therapy drugs".

For the first time, staggered payments and payment based on real-life results are offered.

In summary, if the results are not there for the patients, the payments to the pharmaceutical laboratory will be interrupted.

This measure will actually apply to a few drugs only for the moment, in gene and cell therapy, which cost several hundred thousand euros, we explain to the Ministry of Health.

This concept was greeted with caution by the drug sector.

"If the reimbursement of a treatment is too conditional on performance, laboratories, believing that there are too many risks, could neglect certain sectors of research", estimates health economist Bruno Ventelou.

These performance contract mechanisms, "when they are poorly designed", can push laboratories to move away from certain pathologies, he recalls.

Beyond this single measure, the pharmaceutical industry is very critical of other aspects of the text, which provides for savings on the drug estimated at 1.1 billion euros according to the government, to more than 3 billion according to the federation of pharmaceutical companies (Leem).

Proposals "which will weaken French production and patient access to innovations", denounced Didier Véron, president of the G5 health, which brings together the eight main French health product companies, during a press conference Thursday.

The biology sector is no exception.

To respond to the explosion of expenses during the pandemic, for Covid tests, the PLFSS thus proposes that the diagnostic players work on an agreement "presenting significant savings".

Otherwise, the Ministry of Health could decide to lower biology prices "by decree".

Faced with the sling, the government announced Thursday modulations on some of the most contested points of the PLFSS, such as the use of calls for tenders for certain drugs (for hospitals).

“A government amendment will be tabled to transform this procedure into a simple experiment on a well-defined class of products,” said Minister Delegate for Industry Roland Lescure on Thursday during the G5 health meetings.

© 2022 AFP