Behind the uneventful volumes, the figures presented by health insurance show a shift in medicine expenses towards some very expensive treatments. Here are the ten key indicators that outline the economic framework in which pharmacies will have to operate.
At first glance, nothing seems to change. Boxes continue to pass through the counter, volumes are growing slowly, and the classic medications still dominate dispensing. However, the figures presented by health insurance tell a different story. Over a decade, medicine expenses have been profoundly restructured. The value has shifted towards a few very expensive treatments, mostly hospital-based, while the pharmacy remains the core of therapeutic daily life but with low economic returns. Ten figures are enough to grasp the extent of this shift.
1. €37.9 billion in gross expenses In 2024, the total medicine expenditure reaches €37.9 billion, across all channels. Over five years, it has increased by +44%. This increase is largely disconnected from the evolution of volumes, mainly driven by innovative and costly treatments.
2. €27 billion in rebates Negotiated rebates with the industry amount to €27 billion in 2024, up by +7.2% in a year and +19% over five years. They serve as a central budgetary buffer, without halting the underlying spending trend.
3. 26% of outpatient care expenses Medicine now accounts for 26% of outpatient care expenses. This is a significant share, mainly characterized by an internal transformation where growth no longer comes from routine prescriptions but from specialized treatments.
4. 61.8 million French citizens covered In 2024, 61.8 million policyholders were reimbursed for at least one box of medication. The average consumption stands at 41 boxes per person per year, with an average expense of €437.
5. Consumption spikes with age The average figures hide significant disparities: – 75 boxes per year for those aged 65-79 – 105 boxes for those over 79 This reality fuels challenges like polymedication, deprescription, and treatment safety, with pharmaceutical intervention at the forefront.
6. Nearly 90% coverage The medication reimbursement rate is close to 88%, and 90% when including hospital prescriptions executed in outpatient settings. This level is among the highest in Europe, far exceeding Spain (70%) and the UK (65%).
7. 0.5% of volumes account for a third of expenses Medications with annual costs exceeding €1,000 represent 0.5% of volumes but about a third of the total expenses. The economic fracture in medication is now evident.
8. 21 medications over €100,000 per patient In 2015, only one treatment crossed this threshold. By 2025, there are 21. The top 10 most expensive medications exceed €185,000 per patient annually, sometimes for just a few dozen patients.
9. €3,801 per patient for innovation The average annual cost per patient reaches €3,801 for innovative medications, compared to €161 for those with no demonstrated improvement over existing ones. Between 2017 and 2024, innovation-related expenses have increased from €8 to €10 billion.
10. 33 days ahead of market authorization Thanks to the early access scheme, 120,000 patients benefitted from innovative treatment between 2021 and 2024, with a median delay of 33 days before market authorization. This strongly indicates France’s ability to rapidly afford innovation.
