Around twenty drugs costing more than 100,000 euros per year per patient: the Health Insurance is warning about the explosion in costs of innovative drugs and intends to crack down on treatments that do not bring progress.
In volume, drug consumption has increased slightly (+1.1% per year) over the last five years, but in amount, the bill is climbing because of very expensive drugs.
In 2024, the amounts actually paid by Health Insurance after discounts negotiated with laboratories reached 27.2 billion euros, up 7.2% year on year.
"While in 2015 only one drug exceeded an annual treatment cost of 100,000 euros per patient, in 2025 21 will cross this threshold, and the most expensive treatments now exceed 185,000 euros per patient per year," before discounts, that is to say before the reductions negotiated between manufacturers and the State, according to data from the Health Insurance.
Two drugs, prescribed for a very limited number of patients, even exceed one million euros per year per patient: these are Bylvay, prescribed to 51 patients with a rare liver disease, and Myalepta, prescribed to 39 patients with a serious disease of fatty tissue, knowing that in rare diseases discounts can reach, according to experts, up to 90% of the catalogue price.
– Cancer treatments that cost over a billion –
In 2024, two cancer drugs exceeded one billion euros in reimbursement: Keytruda (2.1 billion euros) and Darzalex (1.05 billion euros), underlines the Health Insurance, recalling that the number of patients treated in oncology increases on average by 3% per year in France.
"It is a cost, but it is a cost in relation to a therapeutic value which meets a real need" for 3 million patients who fight against cancer each year, justified Clarisse Lhoste, president of Agipharm (an association of American laboratories established in France), this autumn.
A study by the International Agency for Research on Cancer estimated the productivity losses due to premature cancer mortality at $566 billion, equivalent to 0.6% of global gross domestic product in 2022.
Although innovative medicines represent only a limited share of volumes, they concentrate a growing share of spending: in 2024, their average annual cost reached 3,801 euros per patient (excluding vaccines), compared to 161 euros for older medicines.
This dynamic is linked to the rise of therapeutic innovations against rare and serious diseases that are now being treated, stressed Thomas Fatôme, Director General of the National Health Insurance Fund, seeing it as "a subject of sustainability" for the health system.
"Medicines costing more than 1,000 euros represent 0.5% of the volume of reimbursed medicines and a third of the total expenditure," explained Sophie Kelley, head of the health products department at the Health Insurance during a press conference.
– “New is not necessarily innovative” –
But a new drug "is not necessarily innovative," she insisted, pointing out that "a third of the drugs reimbursed today and still under patent ultimately bring little or no improvement compared to existing ones."
The amount reimbursed for treatments considered innovative represents an ever-increasing share of reimbursements: from 8 billion in 2017 to just over 10 billion in 2024.
This assessment comes as the framework agreement governing the regulation of reimbursable drug prices is due to be renegotiated with the pharmaceutical industry this year.
Manufacturers regularly argue that 37% of the new drugs authorized in Europe are not available in France and that drug prices there are among the lowest on the continent.
“We are not entirely in agreement on this diagnosis,” Thomas Fatôme argued. “Our system allows effective access to innovative medicines,” he said, but “we must ask ourselves why the average costs of treatments for ASMR IV (minor therapeutic progress, editor's note) and V (no therapeutic progress) are increasing so rapidly,” advocating for “the right care at the right price.”
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