The decline in France the rate of reimbursement of certain medications should have a limited impact on big pharma but could affect small laboratories whose product portfolio is older and less diverse.
To reduce the bill for Social Security, Safety Agency of Health Products (AFSSAPS) has decided to screen 100 to 200 molecules before the end of 2011 in order to judge their effectiveness.
Overall, all the products that we had an authorization on the market before 2005, 4,000 drugs, are potentially threatened with delisting if, in the jargon of the Health Authority (HAS), their "medical service "was deemed insufficient or weak.
Afssaps decides on the basis of recommendations of the Committee on the transparency of the Authority for Health (HAS) that regularly reviews all the French pharmacopoeia.
These measures led last year to reduce from 35% to 15% repayment rate of nearly 200 drugs.Among them, the disinfectant Hexomedine (Sanofi), syrup Polery Child and moisturizer Dexeryl (Pierre Fabre) and Tanakan Ipsen, treatment of memory disorders in the elderly.
A LONG PROCESS
Against the backdrop of suspected adverse liver surrounding the drug, the HAS is also insufficient to judge the medical service rendered by the Multaq, anti-arrhythmic Sanofi now reimbursed at 65%.
The recommendation paves the way for a delisting of a drug that the champion tricolor was a time classified as a product that can generate one billion euros in annual sales.
Thus, the scandal has led the agency Mediator, shunted by the Ministry of Health to monitor more closely the market.
In presenting his reform last June of the drug, the Minister Xavier Bertrand was clear: the community will cease to support the products to the service rendered insufficient.
"We will work in this direction and to screen the pharmacopoeia and eventually everyone will be an inadequate medical service will be subject to a delisting.This process is quite long, "says one to the Ministry of Health.
However, the impact of this decision is deemed marginal on the health of a sector whose growth is fueled by the challenges of aging and demand for new drugs.
In one study, the group Heuler Hermes notes that the profitability of the major players in the system could be threatened by the medium-term structural deficit of health insurance plans leading to lower reimbursement rates to contain health care costs.
But the world's leading credit insurance also notes that to address these pressures, "big pharma" know drastically streamline their costs, by reducing their workforce and by making acquisitions.
In fact, says the analyst of a major bank, "the impact of delisting is limited to large laboratories as they relate to the tail of the portfolio, especially the products of comfort, not innovative products."
The line thickness FOR SANOFI
For large groups such as Sanofi, "it will be the thickness of the line," said his side Arsene Guekam analyst at CM-CIC.
Antoine Dupuy Angeac, portfolio manager at fund management company Acropole Asset Management, also noted that Sanofi impact of government policies was offset by "an extremely drastic cost savings and lower research budgets / development. "
In fact, the unions complained recently in a statement the removal by the French laboratory of 4,500 jobs between 2008 and late 2014 with the closure or sale of eight sites in France.
However, laboratories are not listed as Fabre and Servier, may be more affected by possible delisting.
The experts also point to the particular case of Ipsen, over which hung the threat of delisting Tanakan.But the filing by the company of a new study evaluating the efficacy of the active ingredient of the product in preventing Alzheimer's disease could prompt the authorities to reconsider their position.
In any case, the laboratories which will not be reimbursed drugs will still be able to sell their molecules open access where prices are not regulated which can be used to partially offset the decline in volume related to delisting.
Still, the smaller laboratories are not always equipped to continue selling their products in the circuit.