The cost of the Long-Term Illness (ALD) device, which provides total exemption from co-payments for eligible individuals, has increased by 72% in current euros between 2015 and 2025, reaching 19.7 billion euros in 2025. This represents a significant rise compared to a 40% increase in overall international health expenditures during the same period. The ALD device covers 22% of the insured population of the Mandatory Health Insurance (AMO), or approximately 15 million people, but accounts for 67% of reimbursable health expenditures in 2025. The most expensive pathologies under the ALD device include cancers, diabetes, and cardiovascular diseases. Cancers alone generate a cost of 3.8 billion euros, comparable to the cost of diabetes. Long-term psychiatric conditions contribute 1.1 billion euros, while three cardiovascular ALD conditions—heart failure and heart disease, coronary diseases, and arteriosclerosis—combined reach a cost of 3.9 billion euros. These six most common ALD conditions account for two-thirds of the total ALD expenditure. The increase in the cost of the ALD device between 2015 and 2025 is primarily driven by medical-economic factors, which contribute 37% of the increase. These factors include the rising average cost of treatments, therapeutic innovations, patient survival rates, and treatment prices. Demographic, epidemiological, and medical-administrative factors contribute 25% of the increase, notably the aging of the population (+12%) and the increase in the prevalence of ALD at constant age (+9%). The age structure of ALD beneficiaries also plays a role, as they tend to be older than the average insured population. In 2025, the largest age group among ALD beneficiaries is 70-79 years, compared to 60-69 years in 2015. This reflects the broader aging trend in the French population. Reimbursement rates by the AMO have evolved differently for ALD beneficiaries and non-beneficiaries. For ALD beneficiaries, the reimbursement rate increased by 0.2 percentage points over ten years, from 89.5% in 2015 to 89.7% in 2025. In contrast, the reimbursement rate for non-ALD beneficiaries decreased by 3.4 percentage points, from 62.2% in 2015 to 58.9% in 2025. This decline was most pronounced in 2023 and 2024, influenced by the doubling of co-payments and fixed contributions. These changes have had a more significant impact on non-ALD beneficiaries, although ALD beneficiaries are also affected, albeit to a lesser extent.