France's ALD program covers 22% of insured citizens but accounts for 67% of healthcare costs. A 2026 restriction may shift financial burden to patients.
ALD program covers 22% of insured in France
In 2025, 15 million French citizens benefit from the ALD program, which covers long-term illnesses and chronic conditions. This represents 22% of all insured individuals and accounts for 67% of the 189 billion euros in reimbursable healthcare expenses.Healthcare costs are seven times higher for ALD beneficiaries
The healthcare costs for ALD beneficiaries are on average seven times higher than those of other insured individuals. However, the cost specifically attributable to the ALD program is significantly lower: 19.7 billion euros, or 1,300 euros per beneficiary.Cancer and diabetes cost 3.8 billion euros each
Cancer and diabetes each represent 3.8 billion euros of the ALD program’s cost, compared to 3.9 billion euros for three categories of cardiovascular diseases. These figures highlight the significant impact of specific conditions on the program’s budget.ALD program growth rate outpaces overall healthcare spending
The ALD program has grown rapidly, with a 72% increase in costs between 2015 and 2025, compared to a 40% increase in total healthcare expenses. According to the Drees, this growth is driven by population aging, the rise in chronic diseases, and the increasing cost of treatments.New restriction limits reimbursement for certain medications
A first restriction came into effect on October 1, 2026, limiting reimbursement for medications with low medical service rendered (SMR) to 15%, down from full coverage. This measure is expected to generate 70 million euros in savings in 2026.Patients may face higher out-of-pocket costs
For pharmacists, this change could result in additional out-of-pocket costs for patients, depending on their complementary insurance coverage. This may affect how patients manage their medication expenses.No further general reimbursement cuts planned
At this stage, no further general reduction in reimbursement for care related to ALD is planned. The Health Insurance confirms the continuation of 100% coverage for other related care, ensuring that essential treatments remain fully funded.Future budget decisions remain uncertain
The rising cost of the ALD program could lead to new budgetary decisions. A central question remains: will the savings sought result in a decrease in healthcare expenses or a transfer of their financing to complementary health insurance and patients?
