Le périmètre en mosaïque des médicaments remboursables : pourquoi tant d'exceptions ?

The legal rules which delimit the field of refundable drugs aim at selecting what is regarded as “useful” and must be subject of a socialized financing. However, a growing number of exceptions to these rules seems to exist, including both exceptions “by defect” or “excess”. Analysis of these exceptions allows to distinguish exceptions of a “political” nature of those of a “technical” nature. With a dominating economic dimension, the first have their base in political measures with either public health or social security objectives. The seconds concern intrinsically the drug and the organization of the pharmaceutical distribution, and highlight the limits or insufficiencies of methodologies or procedures of evaluation.