LFrance today devotes 12% of its gross domestic product (GDP) to financing health spending, or more than 300 billion euros per year. Since the 1970s, these expenses have increased by 130%. This increase has been very beneficial for the French: in fact, there is a strong correlation between the growth rate of health spending and the gains in life expectancy of the populations who benefit from it.
Historically, health spending follows economic growth. In a perfect world, a virtuous circle begins: spending helps improve the health of the population, and the resulting productivity gains fuel economic growth, because there is a direct link between health, education and productivity. of work. This growth then makes it possible to increase investment in health. And so on…
In times of crisis, health spending decreases less quickly than GDP, because the social protection system plays its role as a shock absorber. The financing of health expenditure then involves debt which, by making it possible to maintain investment in the health system, creates favorable conditions for the resumption of economic growth. But three reasons make this recovery scenario uncertain today.
The decline in the attractiveness of the French market for manufacturers
First of all, a growing share of health spending is allocated to financing the needs of dependent elderly people, whose contribution to economic growth is a priori reduced. Then, the very degraded financial situation of the hospital and the shortage of care provision lead to massive long-term investment needs, at the very time when the rise in interest rates is deteriorating debt conditions. Finally, drug innovations entering the market have prices negotiated at unprecedented levels, which compromises the system’s ability to finance access.
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Our health policies are currently responding to these challenges by activating two main levers: the increase in the contribution of manufacturers and private insurers to the financing of Health Insurance expenses, and the increase in the remainder payable by patients. These two levers are even more highlighted by the 2025 Social Security financing bill (PLFSS).
In a context where the French market represents only 3% of the global drug market, this strategy could ultimately contribute to reducing access to care for French patients. Indeed, regulatory tools such as the “safeguard clause” or drug delisting reduce the attractiveness of the French market for manufacturers, who risk favoring entry into more buoyant markets.
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