Civil Society Pressures French Leaders To Adopt Transparency Amendments

A coalition of over 40 personalities – from doctors and economists to actors and health access activists – released an open letter Tuesday calling on the French Prime Minister Edouard Philippe and the Minister of Health Agnès Buzyn to support a series of amendments to the French Social Security Budget Bill for 2020 providing for greater transparency around the selection and pricing of drugs purchased for the national health system. The bill, which provides the framework for public health system funding, will be going before the French Senate next week, and drug pricing amendments were previously blocked by the Minister of Health in a presentation of the bill to the National Assembly on October 24th.

“The government’s negative review of these amendments is incomprehensible and politically untenable,” states the petition. Noted French academics, doctors, and cultural figures such as composer Bertrand Burgalat; writer Edouard Louis; economist Thomas Piketty, anthropologist Didier Fassin; and Academy of Medicine member and medical school faculty Alfred Spira, have all signed on to the letter to the Minister of Health and the Prime Minister.

The strongly-worded statement goes on to call the rejection of the price transparency measures a “denial of the French commitment made to the World Health Organization,” referring to France’s vote in favor of the landmark price transparency resolution passed at the 72nd World Health Assembly in May. While political leaders in other European countries such as Malta and Italy have been pushing the transparency agenda, civil society actors such as l’Observatoire Transparence Médicaments (OTM) have been driving the conversation around pricing transparency in France.

The proposed amendments contained in Article 28 of the budget proposal, would provide for the systematic publication of data on prices paid by the public health system for bulk medicine purchases; more detailed patent information, as well as data on public contributions to R&D costs.  The amendments would also give the government more leeway to use the threat of “compulsory licensing” –  to produce a generic version of patented drugs – as a bargaining tool in negotiations with pharmaceutical suppliers, Pauline Londeix of OTM told Health Policy Watch. The amendments were proposed by OTM and presented by Members of Parliament of the left-wing “La France Insoumise” Party to the National Assembly two weeks ago – but were shot down at the first reading of the bill by the Minister of Health.

French Health Minister Agnès Buzyn at the National Assembly on October 24th

“We are all in favor, of course, of a very regular review of the price of medicines. This is a goal we share. But it seems to me that the method proposed to reach it does not correspond to the reality of the facts,” said Buzyn in her negative opinion of Article 28. Buzyn explained that she thought the proposed amendments, such as one clause that requires all drug prices to be reviewed at a minimum every 5 years, would actually “lead to deviant practices” and lengthen the time between price reductions for drugs.

Buzyn claimed that in more than “half the cases” CEPS, the body in charge of negotiating drug prices, actually renegotiates prices in more frequent intervals than 5 years.

Still, the Senate meeting next week will present another opportunity for the transparency amendments to be included in the final version of the budget bill.

There is “a possibility” that the transparency amendments will be accepted at that meeting, before the bill is sent back to the National Assembly for a second and final review by that legislative body before it is adopted, Londeix told Health Policy Watch. “We hope that the Senate will support [the amendments].”