Financement de la psychiatrie en France, la question des médicaments onéreux : exemple de l’Esketamine dans l’épisode dépressif caractérisé résistant

IF 1.2 4区 医学 Q4 NEUROSCIENCES
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Abstract

In France, the funding of mental health institutions relies on an annual budget allocation. Esketamine, a non-competitive NMDA glutamate receptor antagonist, has been approved for adults with treatment-resistant major depressive disorder since 2019. However, due to its high cost (€200 per 28 mg device, excluding tax), the aim of this work was to evaluate whether the income received by an institution for the management of a patient treated with Esketamine could cover the purchase of devices, based on real clinical data. Within our institution, seven patients underwent treatment with Esketamine during the study period resulting in a total usage of 714 devices, amounting to a purchase cost of €142,800. Over the course of the follow-up period, the institution received €149,054 in revenue for the treatment of these patients. Our analysis reveals that the expense associated with Esketamine constitutes 95.8 % of the income generated from caring for these patients. This not only raises questions about the pricing of this drug but also highlights the lack of a funding system for costly psychiatric drugs. This concern extends to somatic treatments associated with psychiatric care.

法国精神病学的资金,昂贵药物的问题。艾氯胺酮在难治性抑郁发作中的应用实例]。
在法国,精神卫生机构的资金依赖年度预算拨款。艾氯胺酮是一种非竞争性NMDA谷氨酸受体拮抗剂,自2019年以来已被批准用于治疗难治性重度抑郁症的成人。然而,由于其高昂的成本(每28毫克装置200欧元,不含税),这项工作的目的是评估一个机构为管理接受埃氯胺酮治疗的患者所收到的收入是否可以根据真实的临床数据支付设备的购买费用。在我们的机构内,在研究期间,有7名患者接受了艾氯胺酮治疗,总共使用了714台设备,购买成本为142800欧元。在随访期间,该机构为治疗这些患者获得了149,054欧元的收入。我们的分析显示,与艾氯胺酮相关的费用占照顾这些患者所产生收入的95.8%。这不仅引发了对这种药物定价的质疑,也凸显了昂贵的精神科药物缺乏资金体系。这种关注延伸到与精神科护理相关的躯体治疗。
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来源期刊
CiteScore
4.60
自引率
7.40%
发文量
162
审稿时长
6-12 weeks
期刊介绍: Une revue française de renommée internationale. - Un comite de rédaction représentant tous les aspects de la prise en charge psychiatrique du patient. - Une sélection rigoureuse d''articles faisant l''objet de plusieurs expertises. - Des travaux d''auteurs et de chercheurs de renommée internationale. - Des indexations dans les grandes bases de données (Current Contents, Excerpta Medica, etc.). - Un facteur d''impact qui témoigne de la grande notoriété de la revue. La tribune des publications originales de haut niveau. - Une très grande diversité des sujets traités, rigoureusement sélectionnés à travers des sommaires dynamiques : - des éditoriaux de médecins référents, - une revue de presse sur les actualités internationales, - des articles originaux pour approfondir vos connaissances, - des mises au point et des cas cliniques pour engager votre réflexion sur les indications et choix possibles au travers de mises en situation clinique, - des dossiers thématiques pour faire le tour d''une question. - L''actualité de l''AFPB : L''Encéphale publie régulièrement des comptes rendus de l''Association française de psychiatrie clinique.
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