France’s minority government has forced through a Social Security & Healthcare Bill for 2026 containing EUR five billion in healthcare cuts. For the country’s beleaguered innovative pharma industry, this Bill represents yet another setback, with stakeholders warning of more access delays, listing withdrawals, and unnecessary patient suffering.
PLFSS 2026: EUR 5 billion in spending cuts, long-term care focus, hospital efficiency, and tackling medical deserts
Prime Minister Sébastien Lecornu’s minority government is in a precarious position, struggling to pass a full budget for 2026 and having to survive repeated no-confidence motions, including two in mid-October. As it lacks a majority, the Social Security & Healthcare Bill 2026 (Projet de loi de financement de la Sécurité sociale (PLFSS 2026) has been pushed through under Article 49.3 of the Constitution, which allows adoption without a vote unless a no-confidence motion passes.
PLFSS 2026 aims to reduce France’s massive social security deficit from EUR 23 billion in 2025 to EUR 17.4 billion in 2026 and achieve budget balance by 2029. As well as doubling the amount which patients pay for healthcare co-payments and deductibles, the Bill proposes stronger regulation of what the government sees as over-profitable health sectors (including radiology and dialysis), as well as drug price cuts worth EUR 1.6 billion (EUR 1.4 billion for medicines, 0.2 billion for devices).
In a push to modernise and rationalise healthcare spending, the Bill includes plans to redesign long-term illness coverage with a focus on severe cases and an expansion of preventive care pathways.
Elsewhere, EUR 2.3 billion has been earmarked for improving the efficiency of the country’s hospitals, while a new ‘France Santé’ network of 5,000 local health centres aims to ensure that every French resident can reach a medical service in under 30 minutes.
Additionally, the Bill supports grouped hospital tenders for specific categories of medicines; an attempt to drive prices down and increase generic and biosimilar competition.
Pricing & Delays
For a French pharmaceutical industry already faced with some of the lowest list prices in Europe and severe access delays, the PLFSS 2026 comes as yet another body blow. Especially for industry sponsors operating in high-spend therapeutic areas like oncology and rare diseases, 2026 is set to be another tough year, with less headroom for new launches and increased scrutiny of their profitability.
Industry leaders warn that while France’s reliance on annual price cuts may yield short-term savings, it erodes the fiscal predictability required for reinvestment in R&D and local manufacturing, undermining the goals of the EUR 54 billion France 2030 investment plan.
As reporting from G5 Santé – an alliance of France’s eight leading research-based pharmaceutical companies – shows, French drug prices are already 30 percent lower than in Germany and 15 percent lower than the EU average. Successive price cuts have weakened local production and led to 40 percent of treatments authorised in Europe remaining inaccessible in France.
“Today, almost every new medicine sees its price reduced immediately, which makes it impossible to sustain innovation,” states Karine Duquesne, general manager for the French affiliate of dermatology specialist LEO Pharma. “The result is that only mature products remain widely available.”
Moreover, France is a market beset by access delays. A dense web of regulatory, pricing, and reimbursement negotiations slows the process, leading to an average time between marketing authorisation and reimbursement/launch of 523 days (compared to 219 in Austria, 204 in Switzerland, and just 52 in Germany), according to the 2025 Patients W.A.I.T. (Waiting to Access Innovative Therapies) Indicator, produced by IQVIA and EFPIA.
There is an international element to this challenging situation too. The US government’s threats to align domestic drug prices with the lowest prices charged in Europe risk exacerbating an already precarious situation. If France becomes a low-ceiling reference country for the US, companies may delay or defer launching in France to avoid depressing prices elsewhere.
This is already playing out within Europe’s borders, where countries like Poland, the Czech Republic, Hungary, and Slovakia explicitly use France as one of their reference pricing countries. In recent years, global firms including AstraZeneca, Vertex, and Novartis have all delayed or withdrawn product listings in France due to its low list prices and their knock-on effects elsewhere.
There are, however, some green shoots of progress, especially for those companies that manufacture within France. The PLFSS 2026 includes language encouraging preferential treatment for drugs produced locally or under low-carbon conditions, aligning with guidance from CEPS (the French pricing committee) to consider sustainability and localisation factors in price negotiations. This is not a completely new development – support for local manufacturing has been expressed in previous bills, although the common industry complaint is that this has tended not to be implemented fully enough.
France is currently experiencing its biggest pharmaceutical manufacturing boom in decades, with global giants like Novo Nordisk, Sanofi, and Pfizer collectively committing over EUR 4 billion in new investments since 2023.
Early Access Reform
Significantly, the PLFSS 2026 introduces reform to the country’s early-access schemes, long held up by the industry as one of the French system’s few strong points. France’s early access system is unique in Europe, allowing companies to start treating patients and collecting data early, sometimes a year or more before reimbursement.
Under the terms of the Bill, Accès précoce (early access) will still exist, but companies will need to repay a larger share of the difference between the temporary early-access price and the eventual negotiated price. There will also be stricter audit and reporting requirements, a shorter window between early access and official reimbursement, and closer monitoring of hospital and insurer spending on these medicines.
Collectively, these changes make France’s early access scheme less financially attractive and more administratively burdensome for sponsor companies. The association of innovative pharma companies in France, LEEM, said last month that PLFSS 2026 “weakens one of France’s few remaining competitive advantages in access to therapeutic innovation.”
“What makes France particularly significant within our network is its early access framework,” adds Takeda France General Manager Nienke Feenstra, in an interview conducted before the PLFSS 2026 was released.
“Through AP1, which allows access before marketing authorisation, and AP2, which provides access after authorisation but before reimbursement, patients with serious unmet needs can benefit from innovation much earlier,” says Feenstra. “The combination of early patient access and meaningful data generation is what makes France stand out, and it would be a real setback if this mechanism were weakened.”
In more positive news, the Bill does expand the scope of Accès direct (direct access) to more therapeutic areas. This mechanism, first launched in 2023, allows medicines already authorised at the European level and recommended by HAS (the French health technology assessment body) to be available to patients before the reimbursement price is officially set. This shortens time to market and allows for the collection of real-world evidence.
Solutions and Next Steps
For pharma industry stakeholders, the annual release of the PLFSS feels like Groundhog Day: more short-term budget cuts and a constrained environment for access to innovation. “This annual approach to budgeting, coupled with a model that continually requires the pharmaceutical industry to absorb costs, has reached its limits,” laments LEO Pharma’s Duquesne. “What we need instead is a long‑term vision and perspective for investment in France.”
Takeda’s Feenstra agrees. “The rigidity of the one-year budget cycle compounds the problem. Healthcare is not something that can be managed in short bursts; prevention and the treatment of chronic disease require continuity across a patient’s lifetime, which by definition demands a multi-year approach. If France is to fully benefit from therapeutic progress, it must simplify procedures and adopt longer-term planning.”
Even without long-term structural reform to the country’s health budgeting processes, France can achieve some major ‘easy wins’ to reduce the deficit, improve patient care, and retain its attractiveness as an investment destination. “We have the potential to free up EUR 13 billion in avoidable spending,” says G5 Santé President Didier Véron.
Véron, referencing a G5 Santé study, suggests that these savings could be achieved by avoiding hospitalisations via prevention and greater use of vaccines, earlier and targeted diagnosis, and better patient adherence to treatments.
G5 Santé has outlined three priorities to restore France’s leadership in health innovation: a multi-year healthcare programming law to provide long-term policy visibility; a dedicated sub-budget to give a clearer picture of the true cost and value of health products; and a pricing system that rewards efficiency gains rather than purely cutting costs.
In the short term, the group is calling for a moratorium on price cuts for medicines made in France, selective price increases for strategically important products, and tax incentives to boost R&D and local production.
It remains to be seen whether policymakers will respond to these appeals. For now, France’s pharmaceutical community faces yet another cycle of short-term constraints. Unless a coherent, multi-year strategy takes shape, it seems that some of the country’s key objectives – from industrial sovereignty to timely patient access – will continue to slip further out of reach.
