CNAM spending on reimbursed medicines
Insider Insights

France: CNAM spending on reimbursed medicines +14.4% in 2021


Total spending by the main health insurance fund (Caisse nationale d’assurance maladie, CNAM) on reimbursed medicines increased 14.4% in 2021 compared to 2020, up significantly from +2.6% in 2020 (versus 2019). Spending on reimbursed retail drugs increased by 15.3% in 2021, driven by spending on COVID-19 antigen tests. The CNAM notes that, aside spending linked to COVID-19, spending remains “dynamic” due to the arrival in retail pharmacies of a number of products which were previously restricted to dispensing through hospital pharmacies as well as sales of a new (unnamed) product to treat cystic fibrosis. Reimbursed spending on liste de rétrocession drugs (ie hospital drugs which can be dispensed to hospital out-patients and charged to the patient’s health insurer rather than the hospital) rose 6.1% versus 2020.  

Reimbursed spending by the CNAM on out-patient care (including care from general practitioners [GPs]) increased by 11.5% in 2021. Total reimbursed expenditure (on out-patient care and on healthcare establishments including hospitals and other care facilities) meanwhile registered growth of 9.2%.  

The CNAM notes that data for 2021 remains heavily influenced by the COVID-19 pandemic. Indeed, reimbursed spending linked to COVID-19 testing and vaccinations accounted for 6% of total reimbursed spending by the CNAM in 2021.  

Source:, “Remboursements de soins à fin 2021”, 10th February 2022 

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