There are a variety of regimes with
very different terms and conditions.
In the end, in terms of tiered copayment, for example, in France the problem is that you have complementary insurance. You have a system to promote or guide the use of the most cost-effective prescription drugs, but then you have complementary insurance that eliminates the work that has been done with these tiered copayments by reimbursing everything. This is one of the issues.
We need to absolutely avoid any type of co-insurance or deductibles based on the listed price of the drug, which reflects nothing now, because it's all about confidential rebates. Any co-insurance copayment based on the listed price should be avoided. At the same time, what is needed is a drug plan that is not an open bar and builds the institutional tools necessary to promote a more rational use of medicine. This is what we see in Australia, for example, with the NPS MedicineWise system. This is what we see in the Netherlands with the Institute for the Rational Use of Medicine. These would be the tools needed in order to make sure that this public drug plan works efficiently to the benefit of the whole population and monitors what's going on to make sure that we always have the highest standards in terms of prescriptions.