Pharmacists should give more advice and fewer medications, according to the government. On Tuesday, the executive asked Health Insurance to work on new rules of the game with pharmacists, insisting that they strengthen “the relevance” of drug dispensing and prevention.

“I hope that pharmacists will strengthen their role as major players in the field of prevention,” writes the Minister of Health, Aurélien Rousseau, in a letter addressed to the head of Health Insurance, Thomas Fatôme, and consulted by ” The echoes “.

Expansion of skills

These discussions were expected. In 2022, Social Security and the unions recognized the essential place taken by pharmacies during the pandemic by signing a new agreement expanding the skills of pharmacists in terms of vaccination and screening.

Given the impact – very favorable but temporary – of the Covid crisis on the finances of pharmacies, Social Security had however planned to resume discussions with pharmacists before the end of 2023. These must start next week. Aurélien Rousseau has just set the main guidelines.

In view of the surge in drug spending once morest a backdrop of the development of new molecules, often costly, the minister is calling in particular for “new mechanisms reinforcing the relevance of delivery and encouraging moderation in the volumes” of drugs supplied.

Fighting shortages

Health Insurance is already working with doctors on the relevance of their prescriptions. Pharmacists might, for their part, be encouraged to limit “polypharmacy” among the elderly, to reduce the consumption of medications for pregnant women or to alert patients regarding their consumption of opioids.

To limit drug bills, the executive would also like pharmacists to offer more biosimilars, cheaper copies of biomedicines. The challenge is that pharmacists find it beneficial to offer these medications as replacements for their “original” as is the case for generics.

Still in the name of “relevance”, but also to better combat drug shortages, the government would welcome pharmacists reducing the number of boxes of medicines provided at once or even distributing medications individually. . A measure provided for in the Social Security budget, but which involves discussing how pharmacists are remunerated in these cases.

Pharmacies in difficulty

More generally, the government is also calling for a review of the method of remuneration of pharmacists. In particular in order to strengthen “the advisory role”. The idea would be that pharmacists would be paid less depending on the price of medicines.

The method of remuneration for pharmacies is a sensitive subject. “The fight once morest the misuse of medicines must not be to the detriment of the pharmacy economy,” warns Pierre-Olivier Variot, president of the Union of Community Pharmacists’ Unions.

The unions are warning regarding the health of pharmacies which now number less than 20,000 in mainland France. “The economic problems of pharmacies which existed in 2019 were completely masked by the Covid crisis but they are reappearing,” insists Philippe Besset, of the Federation of Pharmaceutical Unions of France (FSPF). Fees need to be increased. »

A positive signal for the union, the government says it is keen to “maintain a local pharmacy offer throughout the territory”. “We have pharmacies which are essential for the population, but which do not have enough people to survive. If we want to keep the pharmacy, we have to find fixed payment methods,” insists Philippe Besset.