#SFHS2613354AFrance Adds Seven Weight-Management Medicines to the Public-Sector Approved Medicines List
AI-generated summary for informational purposes only. Not legal advice. See the original source for the authoritative text.
This order adds seven pharmaceutical products to the list of medicines approved for use by public-sector healthcare institutions and services in France. Health insurance coverage is limited to adult weight-management treatment after properly conducted nutritional care has failed, alongside a reduced-calorie diet and increased physical activity. The coverage criteria are narrow. They apply to adults with an initial BMI of at least 40, or at least 35 when accompanied by specified health conditions such as type 2 diabetes, treated hypertension, severe sleep apnea, certain liver or kidney diseases, severe obesity-linked asthma, disabling joint or back conditions, fertility-related needs, or other listed complications.
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Key Changes
- Adds seven pharmaceutical products to France’s approved medicines list for public-sector healthcare use.
- Limits health insurance coverage to adult weight-management treatment after failed nutritional care.
- Sets detailed BMI and comorbidity criteria for reimbursement eligibility.
Obligations
What this law requires
Health insurance coverage for the listed pharmaceutical specialties must be limited to adult patients receiving weight-management treatment after a properly conducted nutritional care program has failed, defined as less than 5% weight loss at six months, and only when treatment is combined with a reduced-calorie diet and increased physical activity.
Coverage may be granted for adult weight-management treatment without comorbidity only where the patient’s initial BMI is at least 40 kg/m².
Coverage may be granted for adult patients with an initial BMI of at least 35 kg/m² only if the patient has at least one listed comorbidity, including type 2 diabetes, treated hypertension, severe sleep apnea, specified liver or kidney disease, severe obesity-linked asthma, disabling joint or back conditions, fertility-related needs, or other listed complications.
For chronic kidney disease cases, coverage decisions must be made after nephrologist advice up to moderate chronic renal insufficiency stages 3A or 3B; for severe or terminal renal insufficiency with a kidney-transplant project, the decision must be discussed case by case collegially with the transplant team and carried out in centers with dialysis facilities.
For Child A cirrhosis cases, coverage must be conditioned on agreement with the hepatologist.