By Hervé Jouves, President of Hygie31
The 2026 PLFSS (projet de loi de financement de la sécurité sociale, or Social Security Financing Bill) is promising savings. But is likely to end up costing more. By seeking to reduce city spending, the government is weakening the frontline of the health system – the very part that prevents the most expensive hospital costs.
Short-term savings, long-term deficits
The measures to cap discounts, reduce pharmacy margins, and tighten the ONDAM (Objectif national de dépenses d’assurance maladie, or National Health Expenditure Projections) in cities are part of a sweeping approach: making quick savings without considering the delayed effects. However, these budgetary “adjustments” are counterproductive: they weaken local health services and therefore the ability to prevent disease.
The projected savings of €7 billion look attractive on paper, but they are fanciful. Every pharmacy closure, every delay in care, or every patient giving up on treatment (which affects one in three French people) contributes to the hospital deficit. Projections suggest that 13,000 additional hospital admissions would result from a lack of early intervention. Every euro "saved" on pharmacy bills ultimately costs the hospital several hundred euros.
Figures that speak for themselves
Vaccination in pharmacies provides evidence of this. In France, pharmacists now carry out more than 50% of flu vaccinations. This central role not only helps meet the vaccination coverage target set by health authorities, but also generates nearly €200 million in annual savings for the National Health Insurance Fund. It's no surprise: getting a flu vaccination in a pharmacy costs €7.50, compared to the usual €30 when done elsewhere. Every day, independent pharmacies demonstrate their role as one of the most efficient health access points: efficient, accessible, and cost-effective for both patients and the community.
The same applies to therapeutic persistence: the silent emergency that costs lives. Improving treatment adherence is not a minor issue; it is an immediate lever to relieve hospital congestion and reduce costs. In severe respiratory disease, nearly 40% of patients in France discontinue treatment within three years; mortality follows the same pattern. In some regions, this stage is reached as early as 12 months. Every instance of non-adherence is an avoidable complication, an additional emergency, and an unnecessarily occupied bed.
The independent pharmacy is our best ally: reminders, medication reviews, proactive follow-up, and coordination with the prescriber. If the dropout rate is so high when the prognosis is life-threatening, what about diabetes, cholesterol, asthma, and high blood pressure?
Let's make compliance a key operational priority and reward these actions at their true value! This means fewer interruptions, fewer hospitalisations, and lower costs – ultimately, more lives protected.
A medical prescription interrupted today means a hospital bed occupied tomorrow.
Une ordonnance interrompue aujourd’hui, c’est un lit d’hôpital occupé demain.
OSyS : field evidence
The OSyS (Orientation dans le Système de Soins, or Health systems guidance) trial perfectly illustrates the increased responsibility given to pharmacists. This system, approved by the Department of Health, enables pharmacies to treat minor ailments (simple wounds, burns, cystitis, conjunctivitis, sore throats, etc.) using secure decision trees and in consultation with doctors. Result: fewer visits to the emergency room, savings in medical time and a reduction in avoidable costs. Deployed in Brittany, Centre-Val de Loire, Occitanie and Corsica, OSyS is set to be rolled out nationwide by 2026. It is a concrete model of territorial efficiency, without creating new expenditure.
Pharmacies as a profitable investment
Pharmacies are not an expense: they are a productive asset for public health. Every day, pharmacists prevent complications, adjust treatments and prevent hospitalisations. The research is clear: every €1 invested in a pharmacy generates up to €10 in savings for the community.
With its extensive network and expertise, the pharmacy system is already a well-established infrastructure. Underfunding it weakens the only network capable of maintaining equal access to healthcare.
Une réforme simple : rémunérer la performance sanitaire
A simple reform: reward healthcare performance
Rather than reducing margins, let's reward results. Let us establish a performance-based payment model based on public health indicators: vaccination rates, screenings performed, treatment compliance. This funding model would encourage positive behaviour and sustain missions that are already economically profitable
The real budgetary choice: prevent or cure?
The 2026 PLFSS risks taxing patients today and hospitals tomorrow. This is a misguided approach, a display economy that will only exacerbate future deficits. Funding prevention in pharmacies means protecting our fellow citizens and preserving our healthcare system. The debate is no longer about how much the pharmacy costs, but how much it saves. One euro well spent at the pharmacy counter is always better than ten spent in the emergency room.
Key figures
- +€200 million: estimated annual savings if vaccination were fully transferred to pharmacists.
- 1 € = 10 € invested in pharmacies generates up to €10 in savings for the community.
- 40 % of patients with severe respiratory conditions suspend their treatment within a year of starting it.