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Hollande's Crusade against Austerity: What Can Pharma Expect?

31 May 2012 Anne-Charlotte Ackermann

The election of François Hollande to the French presidency has brought a wind of change in Europe's handling of the Eurozone crisis. But while Hollande advocates growth measures, the new French President is aware that his country faces difficult times in which austerity will reign. Is this announced balance between savings and stimulus likely to benefit the pharmaceutical industry in France? Or will the new government use austerity efforts required by Brussels as a pretext to put further pressure on manufacturers?

Austerity Prevails in Pharma
Healthcare was not much discussed during the election campaign. But in his program, François Hollande gave a few clues on his near-term vision for the French healthcare system; the main good news being that the president intends to raise the healthcare spending growth target to 3% per year as of 2013. The higher growth ceiling could benefit the pharma market via higher drug spending in the secondary care sector, even though the rationalisation of drug procurement in hospital will tend to slow down growth in that lucrative area. In the primary care segment, however, the prospect remains sluggish as price and reimbursement cuts as well as reduced sales in volume will for sure continue to harm the industry.

But can the government carry on with higher level of price cuts while it appears that growth in healthcare spending is no more driven by spending on pharmaceuticals? Public expenditure on medicines was only up 0.3% in the first quarter; and up 1% in the 12 months ending 31 March 2012. By comparison, expenditure on hospital care was up 3.3% in that later period. Based on experience, however, it safe to assume that the government will not hesitate to tap into the pharmaceutical sector to unlock savings, especially if it gets the support of the French population. For that matter, during the presidential campaign, Hollande has not hidden his intention to cut drug prices, particularly in the generic market. In the last few years, price cuts on pharmaceuticals have averaged EUR500 million per year, with a record peak at EUR650 million in 2012. Reimbursement cuts, control on sales volume and pro-generics measures are set to complement price cuts in the government's upcoming programme.

First Priorities Ahead of Legislative Elections
About a week after her nomination, the newly appointed Health Minister, Marisol Touraine, outlined her priorities for the global healthcare sector but did not actually enter into details. Physician's extra-billing will be quickly controlled and geographical implementation of healthcare practice optimized to "improve access to healthcare", a term that will seduce many electors on the eve of the legislative elections due to be held on 10-17 June. Aside from that first objective, the minister announced the end of tariff convergence between the public and private sector and changes to the controversial HPST law that rules hospital governance; a measure that is expected to please the public healthcare community.

Marisol Touraine is deputy and president of the general council of Indre-et-Loire, and has been in charge of social affairs and healthcare during Hollande's campaign. She is very familiar with healthcare issues and an expert of the French healthcare system. During the electoral campaign, she made controversial proposals such as the instauration of a "right to die".

Biotech in Need of Growth Solutions
And what about stimulus? In light of his energetic plea in favour of growth, François Hollande will certainly look at ways to encourage investments in the biotech and pharma industry as well. And on that subject, the president was recently reminded by France Biotech that the sector is more than ever in need of financial support to fuel its growth.

In conclusion, Hollande is expected to push for pro-growth measures in the pharma and biotech sector, but austerity will be pursued as the new Ministry of Health will shortly face the difficult task of drafting its first social security financing bill.

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