Patients refusing generics will be less well reimbursed from 2022.

Patients who refuse generic drugs offered by their pharmacist without medical justification will be reimbursed less from 2022.

Every year, the government wants to strengthen the use of generic drugs as part of the savings requested from the health sector (3.8 billion in 2019), focusing on two new measures. Thus, the "reimbursement of an insured who would not wish, without medical justification, the substitution proposed by the pharmacist will henceforth be made based on the price of the generic" indicates the press kit of the security financing bill. However, a generic costs 40% less than the originator, according to the Ministry of Health.

"We ask the French who want to access a brand-name drug to put out of their pocket," Minister of Health Agnès Buzyn told the press. "That is to say that they will be reimbursed based on the most expensive generic pharmaceutical drugs unless there is a medical contraindication to the generic", such as an "allergy," she detailed. "It is thus a question of recognizing the same level of support for the care of the same quality," insists the government. "This measure will apply from January 1, 2020, to have the time necessary to support its implementation with patients", it is specified.

Frame the "non-substitutable" statement

The other measure aims to "better regulate the conditions under which physicians" can affix the "non-substitutable" label on their prescriptions, which prevents pharmacists from offering generics in place of original drugs known as "originator," according to Bercy. This mention should be based "on objective medical criteria, defined in conjunction with the national agency for the safety of drugs and health products," explains the press kit.

These measures should allow, in the short term, "less than 100 million euros" in savings, according to Bercy. "The generic/originator substitution rate is currently over 80% in France," but "mechanisms in favour of substitution are showing a certain lack of steam today" justifies the government.

"In France, we have a considerable delay in the use of generic drugs," for her part, lamented the Minister of Health, recalling the effectiveness and the absence of side effects associated with these products. According to her, the use of generics "at a lower cost" is akin to a "citizen gesture": "this allows Social Security to invest in very innovative drugs," in particular to "treat cancers" of children. , argued Ms. Buzyn.

In twenty years, sales of generics have exploded, to represent today 46.5% of drugs sold in pharmacies and reimbursed by health insurance in France. But they will still gain ground over the next few years, believes the French leader in this market, Biogaran. According to his calculations, in ten years, their weight in consumption will be 70%.

New patents will indeed expire and allow labs to expand their offering by launching more copies. The figure, moreover, is nothing extraordinary. In other European countries, such as Germany, where doctors adapt their prescriptions more quickly to the wishes of governments, these products, in principle less expensive than original drugs, "already total 70% to 80% of sales," recalls Pascal Brière. The president of Biogaran.

New products coming to market soon

The industry is thus banking on the development of "biosimilars, "identical to biological drugs (produced from a cell or a living organism or derived from these) whose patents have expired, and which will be, moreover, in addition to being authorized by the health authorities. By focusing on these new products and expanding abroad, Biogaran, a subsidiary of the Servier Group, intends to double its sales by 2027. By 2025, the range of biosimilars of this laboratory could indeed have "from seven to eight" products and represent 20% of its overall turnover, against 2% currently.