France's Cour des comptes highlights pharmacist-led care success and calls for GP coordination reforms to improve healthcare access and prevention.
Osys experiment shows benefits for patients
The Cour des comptes, in its report on the general practitioner system published on September 30, 2026, cited the results of the Osys experiment. This initiative allows pharmacists to handle certain mild health conditions using predefined protocols. According to the 2025 evaluation, 19% of patients managed through Osys avoided seeing a doctor, 3.5% avoided emergency room visits, and 12% avoided inappropriate self-medication.Pharmacists gain new responsibilities
The report also highlights the expansion of pharmacists' roles. They are now authorized to administer vaccines, dispense certain chronic treatments for an additional three months after a prescription expires, provide antibiotics after specific tests, perform colorectal cancer screening, and conduct prevention check-ups.Reorganization of primary care
These changes are part of a broader reorganization of primary care, aiming to improve coordination between healthcare professionals. The goal is to delegate tasks more effectively and ensure a better distribution of care responsibilities among medical staff.Limited pharmacist collaboration
Despite these developments, collaboration between pharmacists and general practitioners remains limited. According to Drees data cited in the report, only 28% of general practitioners in multidisciplinary health centers (MSP) work with a pharmacist at least once a week, compared to 18% outside these centers. Most frequent collaborations are with other general practitioners or physiotherapists.Growth of multidisciplinary centers
However, coordinated care is progressing. In 2025, France had 2800 contracted multidisciplinary health centers (MSP) employing 50,000 healthcare professionals. By the end of 2024, pharmacists made up 7% of the professionals in these centers, compared to 21% for general practitioners and 27% for nurses.Lack of GP leads to lower cancer screening
The report highlights that the absence of a general practitioner reduces access to preventive care. Data from the National Health Data System (SNDS) showed that only 15% of patients aged 50 to 74 without a general practitioner received colorectal cancer screening over two years, compared to 34% of those who saw their GP. For breast cancer, the rates were 38% and 62%, respectively.Even with a GP, lack of visits affects screening
Even when patients have a general practitioner, not visiting them regularly reduces their chances of receiving preventive care. Only 21% of patients without consultations received colorectal cancer screening, and 47% received breast cancer screening. These disparities emphasize the need for better follow-up and the role of pharmacists in identifying patients who are disconnected from care.Proposed measures to improve GP coverage
To address these issues, the Cour des comptes recommends setting a minimum number of patients for self-employed general practitioners. In 2024, 8553 self-employed GPs saw fewer than 200 patients, limiting their ability to provide primary care. Setting a threshold of 500 patients could potentially give 2.5 to 4 million more people access to a general practitioner.Legislative proposal faces opposition
Socialist deputy Guillaume Garot has introduced a bill in the National Assembly, proposing that at least 30% of a self-employed GP's patient load be under the primary care system. This proposal has faced resistance from self-employed doctors, who argue it could be restrictive and counterproductive.
