#SFHS2613958AFrance Adds Pelmeg to the Hospital Add-On Reimbursement List
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This order adds Pelmeg, a pegfilgrastim medicine, to the list of drugs that can be billed separately from standard hospital services in France. Coverage applies only for reducing the length of neutropenia and the risk of febrile neutropenia in adult cancer patients receiving cytotoxic chemotherapy, excluding chronic myeloid leukemia and myelodysplastic syndromes. Hospitals, oncology teams, payers, and Mundipharma SAS are the main parties affected. The practical change is reimbursement access for this specific product and indication when used in eligible hospital treatment settings.
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Key Changes
- Adds Pelmeg 6 mg injectable syringe to the hospital add-on reimbursement list
- Limits reimbursement to a specific chemotherapy-related neutropenia indication in adult cancer patients
- Identifies Mundipharma SAS as the marketing authorization holder or operating laboratory
Obligations
What this law requires
Hospitals may bill PELMEG 6 mg injection syringe 0.6 ml, UCD code 3400894440468, separately from standard hospitalization services only when it is used for the covered indication listed in the annex.
Separate reimbursement by French health insurance for PELMEG is limited to reducing the duration of neutropenia and the incidence of febrile neutropenia in adult patients receiving cytotoxic chemotherapy for a malignant disease.
Hospitals and oncology teams must not claim separate reimbursement for PELMEG when used for chronic myeloid leukemia or myelodysplastic syndromes, as these indications are excluded from the covered indication.