The signatories of an opinion piece emphasize that the adoption of such a measure could "partially alleviate the shortage of psychotropic drugs that has been affecting the country" since the beginning of the year.

A group of health professionals is calling on the State to authorize the reimbursement of certain drugs prescribed in psychiatry even when their indication does not correspond to that for which they are authorized, in an opinion piece published in the daily newspaper Le Monde dated Wednesday.

The signatories – psychiatrists including Professor Antoine Pélissolo, pharmacists and child psychiatrists, the Bicycle association, etc. – deplore the fact that “certain psychotropic drugs are not reimbursed by social security for their use in psychiatry, despite the level of evidence supporting their worldwide recommendation.”

They emphasize that this rigidity "excludes the most disadvantaged patients from access to treatments that are sometimes the only effective ones," "a situation particularly true in outpatient medicine where psychiatrists are more likely to be audited by the Health Insurance Fund for off-label prescriptions," that is, medications prescribed for an illness or disorder other than the one officially authorized by the health authorities.

A shortage of psychotropic drugs in France

However, in psychiatry, 43.5% of prescriptions are written off-label, they point out. These "sometimes essential" medications, they argue, "considerably reduce the need for other (much more expensive, although reimbursed) treatments," as well as hospitalization rates, the frequency of consultations, and sick leave. "The ability for a practitioner to get their patient reimbursed for these medications without being bothered by the national health insurance fund (CPAM) is a low-cost measure that could be adopted by ministerial directive," they write.

The adoption of such a measure could also, according to them, "partially alleviate the shortage of psychotropic drugs that has plagued the country" since the beginning of the year. They are calling for "the establishment of a list of medications that psychiatric patients should be able to access regardless of their financial resources, including if this involves coverage by the national health insurance system (CPAM) even though the drug does not have marketing authorization for that specific indication."

Supplies of quetiapine-based medications, often prescribed to treat schizophrenia and bipolar disorder, will remain difficult at least until the end of the year, the French National Agency for Medicines and Health Products Safety (ANSM) warned on Monday. The health authority is also maintaining weekly monitoring of the situation regarding other antipsychotics (risperidone, chlorpromazine, venlafaxine, and Teralithe), which are facing varying degrees of supply difficulties.

With mental health being a "major national cause" by 2025, these shortages are a hardship for patients, for whom a sudden stop in treatment can have dramatic consequences.