As desired by the former Minister of Health and Prevention, Aurélien Rousseau, the conventional Health Insurance negotiations with the unions of private doctors and those of community pharmacists are now being held in parallel. This concordance of calendars aims to put the question of the quality and relevance of care, in particular for medicines, at the heart of the discussions. Before the confectioners’ truce, a multilateral meeting with organizations representing private doctors made it possible to draw up an initial assessment after eight thematic sessions to review the subjects. And on that of prescription, quite concrete avenues were discussed. Thus, in order to reduce the consumption of antibiotics, a historic objective of medicalized control, the National Health Insurance Fund (Cnam) would like a systematization of rapid diagnostic orientation tests (Trod) and would like regulation of antibiotic therapy prescribed during a teleconsultation. Another priority for which collaboration between the doctor and the pharmacist is a means put forward: polypharmacy, particularly for the elderly. Health Insurance also calls for a systematization of exchanges within this pair to “question compliance and the long-term relevance of medications”.
Medication assessments and reimbursements
Some unions of liberal doctors are even ready to go much further. In the thematic session, they, for example, proposed “allowing the pharmacist to access a counter of the number of months of benzodiazepines taken by patient so that he can refuse dispensing”. Others suggested “strengthening shared medication assessments by the pharmacist and promoting the deprescription consultation, following a shared medication assessment”. But for practitioners, the reduction in drug consumption must also go through the pharmacy: they suggest the delisting of molecules with a low actual benefit (SMR) as well as the reduction of free access for certain therapeutic classes including non-steroidal anti-inflammatory drugs (NSAIDs).
The next working session on the relevance and quality of care is scheduled for January 11. Representatives of private doctors should meet their pharmacy counterparts in the Cnam elevator who have an appointment the same day to start working on their first theme, namely screening for tonsillitis and cystitis. Health Insurance is waiting to have made sufficient progress during the five new thematic meetings with doctors in January before dropping its card on the highly anticipated box of the revaluation of their consultations.
2024-01-05 16:11:32
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