9. Receiving Health Care in France

1. 9.1. General Practitioners
   9.2. Consultants
   9.3. Prescriptions
   9.4. Emergency Treatment
   9.5. Hospital Treatment
   9.6. Maternity Care

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9.3. Prescription Medicines in France - Ordonnances

The rate of reimbursement for prescriptions varies between 35% up to 100%, depending on the type of medicine.

Medicines not considered essential will get the lowest rate of reimbursement, and only a very limited number of medicines are fully 100% reimbursable.

There are four levels of reimbursement, which will be indicated by the colour of the detachable slip that is attached to each prescription.

The rates and colours are as follows:


Table: Prescription Reimbursement Levels

Rate	Colour
0%	Orange
35%	Blue
65%	White
100%	White/Barred

Only 'generic drugs' (as opposed to 'branded' drugs) are reimbursable by the social security system, unless there is no generic substitute for the branded drug.

'Generic' drugs are copies of those 'branded' drugs whose patent has expired. They are normally at least 30% cheaper than the original version. As a cost saving measure, it is a major priority of the government to secure the widespread adoption of generic drugs.

Patients can specifically ask for branded drugs to be prescribed to them, but they will only receive reimbursement at the price and rate of the equivalent generic drug.

As with doctors fees, prescription drugs are also covered by the system of voluntary/complementary insurance.

Most chemists have computer systems connected to both the state system and the main voluntary insurance funds, so, once registered with your local chemist, you may only need to hand over your carte vitale and pay nothing for the prescription.

In other cases you may need to pay that part of the cost not funded by the state system, and then seek reimbursement from your voluntary insurer using the receipt provided by the chemist.

Where the chemist does not operate a computerised system, then you will need to pay up front and make a claim for refund to your local Caisse and your voluntary insurer. Reimbursement will be made directly into your bank account.

This rule will also apply if you insist on a branded drug over its generic alternative, even though a computerised system may be in operation. In short, the chemist will insist you pay for it on the spot, and you will then have to seek reimbursement from your Caisse.

Non-Prescription Drugs

Only chemists are allowed to dispense non-prescription drugs, so will you not find any in your local supermarket or corner shop, as occurs in many countries.

Hitherto, chemists have been obliged to keep these drugs behind the counter, but in 2007 the French government decreed that up to 3000 non-prescription drugs could be made available in front of the counter, although it has been left to the discretion of individual chemists as to whether they choose to place them there. Early indications suggest the idea does not have overwhelming support, particularly amongst the smaller chemists.

The main objective of this change is to try and persuade patients to 'auto-medicate' and thereby reduce pressure on the health service budget.

These drugs do not get any reimbursement from the French health service or your voluntary (top-up) health insurer

Chemists are also free to charge their own prices for these drugs. You will also find that prices vary between chemists. Whilst some offer a competitive price in order to attract customers, others impose a high charge in order to maximise their profits.

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