Drug deprescribing policy and incentives in France

Abstract

Deprescribing inappropriate drug treatments is a public health issue particularly in countries with a high level of polymedication (polypharmacy). Despite the introduction of the term 'deprescribing' in France in 2002 and the clinical practice guidelines, progress in the outpatient sector has been limited. Our article describes the financial incentives adopted by national agreements between the Assurance Maladie (France's compulsory health insurer scheme) and unions of independent practitioners: pharmacists are encouraged to draw up and share medication reviews (since 2018, target population extended in 2022). As the outcomes have been modest, doctors have then been since 2024 also incentivised to offer medical consultations explicitly dedicated to deprescribing, and to prescribe medication reviews to be drawn up by pharmacists. This article describes the new legal framework for outpatient and inpatient services. It calls for the results expected from 2025 onwards to be measured and studied in national health databases, thanks to the coding associated with these new services.

Keywords: Deprescribing; Déprescription; Financial incentives; France; Incitations financières; Médecins; Pharmaciens; Pharmacists; Physicians; Polymédication; Polypharmacy.