Assurance Maladie announces healthcare reimbursement reforms

The French National Health Insurance (Assurance Maladie) is planning several reforms to manage rising healthcare costs.

Starting September 1, 2026, new rules regarding third-party payment (tiers payant) will be implemented in pharmacies. While the current system allows patients to avoid upfront costs if they accept generic drugs, the new rules will extend this to hybrid and biosimilar medicines. If a patient refuses a substitutable hybrid or biosimilar medication without medical justification, they will be required to pay the full price of the original drug upfront. Although they can seek reimbursement later, the amount may be lower than the price paid.

Additionally, the health insurance system is considering reductions in the reimbursement of physiotherapy sessions to address a projected 5.3 billion euro expenditure in 2025. Proposed measures include moving toward a flat-rate payment model instead of a per-session reimbursement, capping the number of covered sessions based on specific pathologies, and implementing degressive reimbursement rates as treatment progresses. The organization also aims to address medical deserts by potentially requiring new graduates to practice in underserved areas, hospitals, or nursing homes.