The government is about to implement groundbreaking measures to optimize healthcare savings

At the dawn of a tense economic period, the French government is undertaking a major overhaul of public health policies. Citing a risk of exceeding expenditures, Catherine Vautrin, Minister of Health, announces a series of unprecedented measures aimed at optimizing savings while maintaining access to care. Among the proposed innovations, doubling medical deductibles raises intense debate, while the revision of rules governing sick leave aims to make employers more responsible and limit reputed abuses. This action plan, which also includes a modification of the status of long-term conditions and a reflection on refunds for thermal treatments, reveals the complexity faced by the state in balancing health interdependence and budgetary stability. Key industries such as Sanofi, Pierre Fabre, and Biocodex are also involved in these adjustments, emphasizing the stakes intertwined between public health and industrial innovation. The government’s intention is part of a broader context of budgetary discipline, highlighting that savings exceeding 5 billion euros are expected by the end of next year, according to various official sources.

Medical deductibles: a controversial doubling to contain healthcare costs

The government highlighted the necessity of adjusting medical deductibles to strengthen the health insurance budget. Currently set at €1 per box of medication and capped at €50 annually, these deductibles are expected to be doubled, with a monthly ceiling of €8. Catherine Vautrin justifies this measure as a reinforcement of the principle of responsible coverage within the healthcare system.

This change aims to curb excessive and sometimes reckless use of healthcare services, perceived as a primary factor in the observed financial imbalance. The minister expressed concern over the myth of unconditional “free” care. Furthermore, this development has elicited mixed reactions among healthcare professionals and users, some citing a risk of forgoing care, especially among the most vulnerable populations. However, the short-term impact of a higher deductible on individual behaviors remains difficult to measure.

Key points of the new deductible

• 💊 Current deductible: €1 per box, annual cap €50
• 💊 New proposal: doubling to €2 per box
• 📅 Unprecedented monthly cap set at €8
• 📉 Goal: make insured individuals more responsible and reduce excessive use

Type of deductible	Current amount (€)	Projected amount (€)	Frequency	Intended effect
Medication deductible	€1 / box	€2 / box	Annually capped at €50 → €100	Encourage moderation in consumption
Monthly cap	None existing	€8	Monthly	Limit potential regular expenses

It should be noted that this decision occurs in a context where several major pharmaceutical groups such as Sanofi, Pierre Fabre, and Merck are closely monitoring regulatory developments, fearing an indirect impact on the prices and volumes of prescribed medications. An in-depth analysis of the economic and social implications is already underway.

Management of sick leave: moving toward strict limitations and partial transfer to employers

Regulating sick leave is at the core of the government’s strategy to contain runaway expenses. One of the main innovations involves delaying the coverage of daily indemnities by Health Insurance from 4 to 7 days, thus transferring this cost to employers. While this decision is seen as a way to encourage moderation, it sparks lively debate among business leaders and unions.

The government also recommends limiting the maximum duration of initial sick leaves to 15 days in outpatient medicine, compared to the current unlimited duration, and to one month for hospital discharges. This measure aims to combat some “abuses” reported in the sector, with detected fraud reaching €42 million in 2024, a significant increase compared to the previous year.

Strategic points around sick leave

• 🔄 Transfer of the first 7 days of indemnities to employers
• ⏳ Maximum duration for the first outpatient sick leave: 15 days
• 🏥 Maximum duration post-hospitalization: 30 days
• 💰 Key figure: €42 million detected in fraud in 2024

Measure	Current situation	Projected position	Expected impact
Coverage of sick leave indemnities	First 4 days covered by employer, then by Health Insurance	First 7 days covered solely by employer	Reduce abuse through employer responsibility
Duration of the first sick leave	No limit (Unlimited initial leaves)	Limited to 15 days in outpatient medicine	Regulate the length of sick leaves

Beyond the figures, the debate remains lively regarding the actual impact on employees’ health. Experts emphasize the risk of increased pressure on workers, which could lead to unintended effects. This political choice is especially critical as it resonates with the issues raised by economic analyses from groups such as Ipsen and Boehringer Ingelheim scrutinizing the reform and its effect on care consumption in the short and medium term.

Revision of thermal treatment reimbursements and low-SMR medications

Among the proposed measures, the review of full reimbursement for thermal treatments is debated. Currently reimbursed at 100%, they account for an annual cost of €350 million for health insurance, which is a significant but relatively small item in the overall budget, approximately 0.1%. The government considers that these expenses could be better targeted, including by completely removing coverage for certain drugs with low efficacy.

The Court of Auditors, in its latest report, recommended stopping reimbursement for prescribed thermal treatments, suggesting a tightening of criteria. This recommendation aligns with a desire for rationalization expressed by the minister and highlighted in specialized media, such as Les Echos.

Summary of issues concerning thermal treatments

• 🏖️ Thermal cure: currently reimbursed at 100%
• 💸 Budget: approximately €350 million/year, about 0.1% of the health budget
• ⚖️ Medical debate: clinical benefits vs. rest effect
• 📜 Recommendation: abolition of reimbursement prescribed by general practitioners

Aspect	Current situation	Government proposal	Presumed consequence
Reimbursement of thermal treatments	100%	Possible end of full reimbursement	Nett reduction in costs for health insurance
Low-SMR medications	Variable coverage	Elimination of full reimbursement	Rationalization of expenses

The positioning of companies such as Novartis or AbbVie could evolve based on these changes, as the list of affected medications might be reviewed regularly, impacting both markets and pharmaceutical research.

Long-term diseases (LTD): a managed exit to control costs

Long-term diseases, which include severe pathologies with 100% reimbursement, are also in the sights. The government now aims to cap reimbursements to only medications directly related to LTD and to establish an exit from the system when the patient’s health no longer requires this specific coverage.

This measure raises serious concerns among health professionals, who fear an overly administrative management of the system at the expense of patients. The central question concerns the criteria for determining eligibility for the system. Clinical complexity makes this subject highly sensitive, especially given that premature discontinuation of treatments can be severe.

Requirements and principles surrounding LTD

• 🩺 Reimbursement at 100% limited to medications related to LTD
• 📋 Possible exit from the system in case of proven recovery
• ⚠️ Risks: clear criteria must be defined to avoid abuses
• 🔬 Increased medical surveillance required

Dimension	Current system	Planned reform	Expected impact
Non-LTD medication coverage	Reimbursement at 100%	Gradual removal of reimbursement	Expenses rationalization
Exit from the LTD system	Generally, no automatic exit	Possible exit after medical evaluation of recovery	Cost reduction in the medium term

These decisions will be closely monitored by care structures, and it is noteworthy that some of them, such as Ipsen, will participate in the evaluation of relevant clinical criteria.

Mandatory vaccination in EHPAD: a strengthened health prevention measure

As part of strengthened preventive measures, influenza vaccination in EHPAD (nursing homes) becomes mandatory, with a coverage target of 95%, up from 85% currently. This requirement aims to protect a particularly vulnerable population and prevent overloading hospital services during the winter season.

The government emphasizes the importance of a preventive policy to reduce costs associated with secondary complications and avoidable hospitalizations. This approach is inspired by practices in several European countries and studies highlighting the health and economic costs of seasonal epidemics.

Key points of the vaccination policy in EHPAD

• 🏥 Influenza vaccination mandatory in EHPAD
• 🎯 Coverage goal: 95% of residents
• 📉 Reduction in influenza-related hospitalizations
• 💉 Reduction of health expenses in the medium term

Current status	2025 target	Expected consequence
Influenza vaccination coverage in EHPAD	85%	95%	Improved resident health

This measure is supported by health authority recommendations and has the implicit backing of several laboratories such as L’Oréal (through its healthcare subsidiaries) and Vilmorin, which are committed to promoting innovations related to public health and prevention.

Limiting medical nomadism: ensuring coherent medical follow-up

An additional issue raised by the government concerns “medical nomadism,” namely, the multiplication of consultations without real added value. This practice, often motivated by seeking multiple opinions, generates significant costs and complicates medical record management. To address this, repeated unjustified consultations will now be less covered by Health Insurance.

This decision aligns with a policy promoting care continuity through shared medical records, a tool that facilitates coordination among healthcare professionals. The goal is to encourage quality and relevance in care while limiting unnecessary interventions.

Key measures against medical nomadism

• 🩺 Repeated consultation: limited coverage
• 🗂️ Strengthening the use of shared medical records
• ✅ Encouragement of regular follow-up by a primary care physician
• 💸 Reduction of costs related to unnecessary consultations

Before reform	Envisioned measure	Expected effect
Multiple consultations without coordination	Coverage limited beyond the second opinion	Reduction of unnecessary expenses
Poor use of shared medical records	Mandatory promotion of shared records	Improved follow-up and medical exchanges

Reactions of healthcare sector stakeholders regarding government measures

Government announcements evoke various responses from industry, medical professionals, and patient associations. Pharmaceutical companies like Biocodex, Novartis, and AbbVie are closely watching evolving regulations concerning reimbursements, aware that these changes could significantly restructure pharmaceutical markets.

On the other hand, medical unions point out a risk to the quality of care, especially with limits on sick leave and reimbursement caps. Several organizations emphasize the need for a delicate balance between economy and patient support, warning that overly restrictive measures could lead to deferred costs, notably through increased untreated complications.

Non-exhaustive list of notable positions

• 🏥 Pharmaceutical companies: caution and adaptation to new constraints
• 🩺 Healthcare professionals: vigilance in maintaining care quality
• 👥 Patient associations: fears of care abandonment
• 📊 Economists: mixed reception, call for careful impact monitoring

Actor	Position	Key argument
Pharmaceutical companies	Monitoring and adaptation	Impact on market and research
Medical unions	Caution and vigilance	Care quality at risk
Patient associations	Fear of abandonment	Potential access to care issues
Economic experts	Balanced analysis	Importance of impact monitoring

This diversity of opinions illustrates the major challenge faced by the country’s health policy — balancing budget constraints with social imperatives.

Potential impact on health insurance and household expenses

The new measures announced will also influence the supplementary health insurance sector. Doubling medical deductibles and limiting sick leave could lead to increased demand for better-suited supplementary coverage to accommodate these higher costs.

In parallel, some companies in the sector, such as Ipsen and Biocodex, as well as pharmaceutical distribution players like Boehringer Ingelheim, anticipate evolving insured behaviors, especially in terms of care utilization and mutual insurance adherence. This dynamic could thus shift financial pressures among Social Security, supplementary insurers, and policyholders themselves.

Consequences for households and insurance providers

• 📝 Expected increase in supplementary health insurance contracts
• 💳 Rise in direct expenses for users
• 🏥 Adjustment of insurance offerings to the new regulatory framework
• 📉 Partial reduction of public deficit via these measures

Factor	Current situation	Projected consequence
Medical deductibles	Annual cap €50	Doubled to €100
Sick leave indemnities	Started at the 4th day	Delayed to the 7th day
Cost for policyholders	Limited	Expected increase in out-of-reimbursement expenses

This transformation profoundly influences the health insurance market. Several sources, such as Aide BTS Assurance, have analyzed these new configurations as part of a series of studies on the upcoming impact of these measures.

Perspectives and challenges of the government’s healthcare savings plan

Ultimately, all these measures reflect a strong resolve of the executive branch to enforce renewed budget discipline. By combining efforts related to deductibles, sick leave regulation, LTD restrictions, and thermal treatment reforms, the envisaged savings could reach unprecedented levels. Several experts and reports estimate that the expected savings could approach or exceed 5.5 billion euros.

However, as with any major change, managing social and health risks remains central to the discussions. The key challenge is to preserve the quality of the French healthcare system while controlling costs. The government calls for determined and coordinated action, acknowledging potential resistance from various stakeholders and users.

Main issues and points of attention

• 📈 Target approximately €5.5 billion in savings
• ⚖️ Need for a balance between savings and care continuity
• 🔍 Strengthened monitoring for potential abuses
• 🤝 Call for collective and concerted mobilization

Measure	Expected savings	Associated risks	Proposed solutions
Doubling medical deductibles	€1.2 billion	Care abandonment	Information and adjustment according to profile
Limiting sick leave	€1.5 billion	Pressure on workers	Strict medical oversight
LTD reform	€1.0 billion	Medical abuses	Clear criteria and transparency
Reduction of thermal treatment reimbursement	€0.8 billion	Professional opposition	Comprehensive communication

For more detailed information, see: France Info – Healthcare savings 2025, Aide BTS Assurance – Healthcare savings measures, and Les Echos – Healthcare savings plan 2025.

Frequently asked questions about the new healthcare savings measures in 2025

• ❓ What does the doubling of medical deductibles imply for patients?
  The annual cap increases from €50 to €100, with a monthly ceiling of €8. This means insured individuals will contribute more financially to medical expenses.
• ❓ How will the limitation of sick leave affect employers?
  Employers will cover the daily allowances for the first 7 days of absence, a measure aimed at reducing abuse.
• ❓ Will thermal treatments still be reimbursed?
  A withdrawal of 100% reimbursement is planned, especially for prescriptions made by general practitioners, with the specific goal of reducing expenses.
• ❓ How will LTD (Long-Term Diseases) be regulated?
  The reimbursement will be limited to treatments directly related to LTD, and a system for medical evaluation of recovery is being introduced to enable system exit if the patient is cured.
• ❓ How are healthcare professionals reacting to these measures?
  They express reservations, fearing a decrease in care quality and additional pressures on patients.

Source: www.previssima.fr