The new system, provided for in the conventional amendment, which makes it compulsory to present the Vitale card for the dispensation of certain medications, under penalty of not being able to benefit from third-party payment, risks making the daily exercise more complex.
On January 22, during the National Permanent Joint Technical Committee (CTPPN) which brought together the two unions representing the profession and health insurance, the case of the third-party payment system against Vitale card – provided for in the conventional amendment published by decree of Last July 5 – was mentioned.
For the record, article 11 of this amendment provides for strengthening the use of the Vitale card in the exercise of third-party payment in certain cases identified by health insurance. For example, for medicines likely to be the subject of trafficking: diabetes medicines and medical devices, narcotics and similar drugs (TSO) or even medicines costing more than 300 euros. For these dispensations, presentation of the Vitale card will be mandatory to obtain third-party payment. An obligation which is far from responding to the reality on the ground, as Pierre-Olivier Variot points out. The president of the Union of Community Pharmacists’ Unions (USPO) also recalls that the pharmacist has a legal third-party payment obligation for people on long-term care, during a work accident, or even for women. speakers. Consequently, the CNAM’s decision may place pharmacies in delicate situations. “What should you do if a pregnant woman with gestational diabetes cannot access her insulin because she does not have her Vitale card with her? Or the elderly who delegate to relatives the collection of their treatment at the pharmacy? Not to mention the reaction of patients undergoing OST who will not be able to present their Vitale card…”, he asks himself.
Regarding diabetic patients, another measure worries the president of the USPO. A Cerfa form will be available in the coming days to govern prescriptions for GLP-1 analogues. Among the justifications for this prescription for coverage by health insurance, intolerance to metformin. This condition must be met for all prescriptions, new and old, says Pierre-Olivier Variot, who specifies that patients have three months to present this document. “It’s going to be difficult for our patients to get an appointment with their diabetologist so quickly”he denounces adding “this is the first time that a prescription will have to be justified retroactively! “.
-New constraints to which vulnerable patients will have difficulty complying, notes Gérard Raymond, president of France Assos Santé. He protests against these additional restrictions on access to care. “We have the right to be forgotten”he says about third-party payment against Vitale card, and considers that it is absurd to suspect a diabetic patient, known for several decades by his pharmacist. Gérard Raymond is worried that this speech “more guilty than responsible”which today targets certain categories of patients, does not extend transversally to all socially insured persons.
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