· Oct 14, 2022

PLFSS 2023 - What's new for health technology ?

The Social Security Financing Bill (PLFSS) for 2023 has been recently unveiled. This PLFSS is marked by a context of difficulties in access to care accentuated by the Covid-19 crisis and by the Government's desire to invest more widely in the field of prevention.

Some measures, that may be of interest for health technologies' Market Access, have been identified:

โ–  Creation of a contribution for high-growth drugs and high sales, extension of the scope of the safeguard clause, introduction of staggered payment for innovative therapies, strengthening of security of supply obligations.

โ–  Establish the distribution of value (product price, distribution/service margin) by simplifying the pricing methods for products and services on the LPP:

  • Product price: bilateral negotiation between the CEPS and the device operator;
  • Remuneration for distribution: set by regulation, as in the drug sector, following consultation between the ministers responsible for health and social security and representatives of distributors;
  • Case of a service associated with the device: bilateral negotiation between the CEPS and the professional unions;
  • Control of commercial discounts (as for drugs) -> transparency of the sector.

โ–  Improved market transparency: Declaration to CEPS by the operator (when not the manufacturer) of the price at which he buys the device from the manufacturer/wholesaler.

โ–  Request for reimbursement on the full scope of the CE mark: 

  • In case of request for reimbursement on a perimeter more restricted than that of the CE marking -> application of compulsory discounts set by ministerial order.
  • Objective: to encourage manufacturers to apply for reimbursement on the entire scope of the CE mark.

โ–  Reinforce the control of devices generic lines : 

  • Simplification of administrative procedures for operators/distributors by eliminating the declaration to the ANSM.
  • Control of compliance with the conditions of PEC of products and services by the CNAM.
  • Strengthen the fight against fraud.

โ–  Improving data collection and conducting post-reimbursement studies: Implement mandatory discounts, indexed on the amount reimbursed for the specialty in case of non transmission of data related to an IPE within the required timeframe.

โ–  Ensure fair treatment:
In fast track reimbursement (PECT):

  • Introduce a legal framework for the registration of the procedure in the CCAM by derogating from the common law procedure.

In Tele-monitoring:

  • Payment of a registration fee (644€ to 3,220€).
  • Postponement to July 1, 2023 (instead of January 1, 2023) of the changeover from the financing of the ETAPES experiment to common law financing (art. 36 of the LFSS 2022).
  • The actor responsible for transmitting the digital solution's utilization data to the health insurance should be both the operator and the operator.
  • New formulation of real-life monitoring indicators for these activities.

โ–  The implementation of prevention appointments at key ages of life, 20-25 years for primary prevention, 40-45 years for the prevention of chronic diseases, 60-65 years for the screening of the first fragilities or loss of autonomy.

โ–  Access without prescription and free screening for sexually transmitted infections for all and emergency contraception for all women.

โ–  Creation of an ad hoc status for teleconsultation companies to structure their activities.

โ–  Allowong the ministers in charge of social security to implement tariff cuts by regulation in the absence of a conventional agreement with the biology sector, allowing for savings of 250 million euros from 2023.