Covid-19 screening: the heavy bill for French tests

There was the great spring mess on masks, this fall highlights the failure of the management of Covid-19 screening tests, which have become a real business. With 1.19 million tests carried out in the week of September 7, France, which has become the third testing country in the world, spent 88 million euros to detect contaminated cases. Since the start of the pandemic, more than twelve million checks, the vast majority by the so-called RT-PCR technique, with nasal swab swab, have been carried out, bringing the overall bill to nearly 917 million euros this week. Invoice covered 100% by Health Insurance. At this rate, 30 million tests will have been carried out by the end of the year and more than 2.2 billion euros spent.

“An expense that must be related to the avoided cost of re-containment,” argues the economist expert in social protection Frédéric Bizard. The problem here is that it is open bar : the expenditure is not optimized, it is mismanagement, it is necessary to prioritize the tests ”. A shift that the Minister of Health Olivier Véran has been trying to initiate for a week.

A completely clogged system

Especially since the system got carried away and no longer keeps its promises, as Nicolas testifies: “I had a doubt, I went to be tested on August 31 on the site of the Town Hall, says this 28-year-old Parisian archivist. Fifteen days later, I still don’t have my results! The laboratory is overwhelmed ”. An increasingly frequent case which illustrates the congestion of a system where 90% of tests are carried out by the private sector. Taking advantage of the tension, some Parisian laboratories would abuse it, promising results within 48 hours, for 80 or 100 euros per test, revealed Europe 1. Practices firmly condemned by Health Insurance this Wednesday, September 16.

This is a consequence of mistakes made by the authorities, who first authorized the tests only in hospitals, then extended them to private laboratories but required them to only obtain supplies from four manufacturers (out of 187). , have limited the number of approved platforms to 70 (Editor’s note: analysis processing sites depending on laboratories) to analyze the samples from the existing 900, before allowing everyone to test themselves …

A price negotiated with the labs

However, this test boom is making people happy: analytical laboratories and manufacturers. The rate reimbursed by health insurance for each PCR test was set at 73.59 euros after negotiations between professional unions and Health Insurance. Neither Jérôme Salomon, the Director General of Health, nor Nicolas Revel, then Director of Health Insurance (and now Chief of Staff to Prime Minister Jean Castex) responded to our requests for an explanation.

This price is however clearly higher than that practiced in our European neighbors… “The profitability is around 30%, estimates Frédéric Bizard. The laboratories, which had lost 250 million euros in turnover due to the confinement of patients, see these tests as a boon, which have already brought in more than one billion euros in turnover ”.

Covid-19 screening: the heavy bill for French tests

But the current saturation has other causes as well. “We organized ourselves to meet demand, but we come up against manufacturers who impose quotas of reagents,” annoys Dr. François Blanchecotte, president of the Union of biologists. “We have an allowance system, based on health and technical criteria,” confirms Mark Osewold, president of Roche Diagnostic France. In France, laboratories have invested little. There are only 23 very high speed analysis machines, while there are over 100 in Germany. So we give them more reagents ”. Roche sells its PCR reagent “12 euros to all countries”, insists Mark Osewold. Hologic charges them 18 euros… A selling price that should allow analysis laboratories to invest in increasing their productivity.

Very powerful analysis robots at 150,000 euros

The Cosem did it. “We carry out 400 to 800 tests per day and we always return the results within 24 hours, loose Vincent Pargade, head of the laboratory of this non-profit association which manages several health centers in Paris. To do this, I bought a very high speed analysis robot for almost 150,000 euros, which will be amortized over five years, and I have just bought a second one. At 73.59 euros per test, I have no reason to complain, smiles the microbiologist. I do not understand the strategy of the large groups which did not make this choice ”.

“They are there to make money,” slips Patrick Lepreux, president of the Bioprat union, which went on hunger strike to protest against the arrival of investment funds.

Towards a lower price paid to laboratories?

Since the 2013 reform, in fact, the sector has been undergoing major changes. Many small laboratories have had to sell themselves to these funds or to groups. Synlab, Cerba, Eurofins… The first six groups own 60% of the sampling and analysis sites. Biogroup LCD, the leader, groups together 700 and holds 22% of the market. For example, one of its members, BPO-Bioepine, achieved 85 million euros in turnover in 2019 and a profit of 10 million euros. But the employees did not take advantage of it. “To compensate for the hellish pace, management offered staff a premium of 1.25 euros per test to be shared between staff. In other words, ”slips an employee whose salary has not changed for seven years. Employees of Biofusion, based in Montauban (Tarn-et-Garonne), went on strike Tuesday to obtain a bonus and a salary increase.

Faced with the exceptional volume of Covid tests performed today, and the resulting bill for Health Insurance, the government is considering reducing the amount reimbursed to laboratories. A rumor that has not been confirmed by the Ministry of Health.

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