#SFHS2613502AFrance Adds Six Medicines to the Public Sector Approved Medicines List
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The order adds six pharmaceutical products to the list of medicines approved for use by public hospitals, local authorities, and other public services in France. Health insurance coverage is limited to specific weight-management cases in adults, mainly severe obesity after a properly followed nutrition program has failed. Coverage applies only alongside a reduced-calorie diet and increased physical activity, and only for patients meeting strict BMI and related health-condition criteria.
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Key Changes
- Adds six pharmaceutical products to France’s approved list for use by public-sector healthcare and public services
- Limits health insurance reimbursement to adult weight-management cases after failed nutritional management
- Sets strict eligibility criteria based on BMI thresholds and specified obesity-related comorbidities
Obligations
What this law requires
Limit health insurance reimbursement for the listed pharmaceutical specialties to adult patients whose properly conducted nutritional management has failed, defined as less than 5% weight loss after six months.
Provide reimbursed treatment with the listed pharmaceutical specialties only as an adjunct to a reduced-calorie diet and increased physical activity for weight management, including weight loss and weight maintenance.
Allow reimbursement without a comorbidity only for adult patients with an initial BMI of at least 40 kg/m².
Allow reimbursement for adult patients with an initial BMI of at least 35 kg/m² only where the patient also has one of the specified comorbidities listed in the annex.
Treat isolated hepatic steatosis as insufficient to qualify as a comorbidity for the reimbursed indication related to bariatric-surgery eligibility.