France
2006: Reimbursement of anti-dementia drugs
The availability of medicines in general
France has different reimbursement levels for medicines depending on the efficacy of the medicines and the seriousness of the disease or symptoms. Reimbursement can thus vary between 30% and 70% with medicines for certain diseases being reimbursed 100%.[1]
The availability of Alzheimer treatments
All anti-dementia drugs are available in France and are fully reimbursed at 100% through the reimbursement system. There are no specific examinations which are specified by the reimbursement system, but reimbursement of acetylcholinesterase inhibitors is limited to people with Alzheimer’s disease with an MMSE score ranging between 26 and 10 and memantine to patients with an MMSE score below 15.
The French system requires the initial treatment decision and prescription to be done by a specialist (a neurologist, psychiatrist or geriatrician), whereas continuing treatment prescriptions can be filled in by general practitioners as well. There are no restrictions as to the access of people living alone or in nursing homes to available Alzheimer treatments.
France Alzheimer clarified that although the market authorisation for all four products is for Alzheimer’s disease, the French system also has a system of temporary authorisations (“autorisations temporaires d’utilisation”) for diseases for which no treatment is available. Under that system, some people with Lewy body dementia, vascular dementia and Parkinson’s disease dementia also had access to these treatments.
Rivastigmine | Galantamine | Memantine |
||
Reimbursement | Yes | Yes | Yes | Yes |
Initial treatment decision | Specialist doctors | Specialist doctors | Specialist doctors | Specialist doctors |
Continuing treatment decision | No restrictions | No restrictions | No restrictions | No restrictions |
Required examinations | None | None | None | None |
MMSE limits | 26-10 | 26-10 | 26-10 | 15-0 |
People living alone | No restrictions | No restrictions | No restrictions | No restrictions |
People in nursing homes | No restrictions | No restrictions | No restrictions | No restrictions |
[1] European Commission (2006): MISSOC – Mutual information system on social protection : Social protection in the Member States of the European Union, of the European Economic Area and in Switzerland : Comparative tables
Last Updated: Wednesday 15 July 2009