Reimbursement of pharmaceutical products in the retail setting
In order to be dispensed and reimbursed in retail pharmacies, any new pharmaceutical product should be registered on the list of pharmaceutical products reimbursed to persons insured by National Social Security (Liste des Produits Remboursables aux Assurés Sociaux). Registration is subject to positive opinion of the HAS and subsequent approval by the Ministry of Health. Generic pharmaceuticals are not assessed by the HAS and can be registered directly on the basis of the Marketing Authorization. Original medical prescription is mandatory for any reimbursed pharmaceutical product including generics and biosimilars.
Distribution of pharmaceuticals in the retail setting mainly goes through classic distribution channel Wholesalers → Pharmacist) though some retail pharmacies and groups of pharmacies purchase directly from the manufacturer (about one third of volumes were distributed this way in 2014). Wholesaler’s and retail pharmacist’s margins (both direct and indirect) are regulated by law; their amount is calculated from manufacturer’s price without VAT. Retail pharmacist purchasing directly from the manufacturer can capture the wholesaler’s margin. Both manufacturer’s price without VAT and public price including VAT are published in the Official Journal. VAT applied to pharmaceuticals is 2.1% for reimbursable and 10% for non reimbursable medicines.
Prescription drugs delivered in retail pharmacies are charged directly to the National Insurance according to their reimbursement tariff and rate, the remaining part being charged directly to complementary private insurance, so that in majority of cases there is no out-of-pocket expense for patient (third-party payment system).
Substitution of off-patent drugs by generics by retail pharmacist is allowed and financially encouraged. Patients who want to get off-patent original product cannot benefit from third-party payment and should advance money.
Some pharmaceutical products are restricted to hospital prescription and can be delivered to outpatients only by hospital pharmacies. They should be registered on the Hospital Retrocession List.
Updated on December 15th, 2016