HEALTHCARE MADE IN FRANCE EXCELLENCE IN PATIENT CARE
UNDER THE UMBRELLA OF THE FRENCH HEALTHCARE INDUSTRIES AND TECHNOLOGIES STRATEGIC COMMITTEE
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TABLE OF CONTENTS
HEALTHCARE MADE IN FRANCE
EDITORIAL
PROFESSOR PIERRE CORVOL Emeritus Professor at Collège de France Honorary Director of Collège de France
Advances in healthcare Another strong point in France’s number of associations that are are driven by original, favour is the development of giving new impetus to the funding innovative, high-quality structures to evaluate the outcomes of French research, in both rare and biomedical research and of basic research using scientifically common diseases. The clinical and Aits rapid application to diagnostics, rigorous methods under the best genetic diagnosis of the 7000 rare treatment, healthcare and public possible regulatory and safety diseases that affect over two million health. France is a leader in the field. conditions imposed by the health people in France, is aided by rare authorities, such as early therapeutic disease reference centres set up in Its research teams, in which drug trials, cell and gene therapies various hospitals. An ambitious plan researchers and physicians work and medical devices. This so-called in the field of genomic medicine, side by side, have brought it to translational research benefits from called France Médecine Génomique the forefront of basic biomedical dedicated facilities in the form of 2025, whose aim is to provide research. INSERM, the country’s clinical research centres, in which access to genetic diagnostics national institute of health and France is a precursor among the throughout the country, has just medical research and Europe’s European countries. Epidemiological been launched by the Prime Minister leading biomedical research and public health research in chronic in support of academic, hospital and organisation, comprises many teams, diseases is one of its priorities, industrial research in the field of working in both basic research so that patients can benefit precision medicine, one of the major and the human and social sciences from diagnostic, therapeutic and challenges in medicine today. applied to medicine. INSERM is a healthcare advances, with the accent major centre of expertise and know- on prevention wherever possible. France can be proud of the know- how, which attracts the participation Healthcare systems are evolving how it has acquired and continues of other institutes on the leading rapidly and making increasing use to share. It can be proud, too, of the edge of research. A leading example of outpatient medicine, connected many economic and organisational is the Pasteur Institute whose objects and eHealth. solutions it has developed, proud development of new screening of how it has efficiently organised tests and vaccines continues to France’s contribution to gene access to healthcare and medicines, put French scientists at the cutting therapy is an excellent illustration and proud of the generosity of its edge of scientific discovery across of the country’s performance in healthcare system in covering their the globe. France’s reaction and innovative therapies and their costs. The life expectancy and rapid response to the Ebola crisis applications. Gene therapy, launched quality of life of its citizens are through INSERM and the Pasteur at the Necker Children’s Hospital to ample proof that France today can Institute demonstrate the crucial treat young patients with severe propose comprehensive solutions to importance of the discoveries and immune deficiencies, has produced improve healthcare and treatment inventiveness of French researchers results that are attracting the throughout the world that can be on the international stage. Other key attention of medical teams worldwide adapted to each healthcare system institutes engaged in basic research and are encouraging the entire in accordance with societal choices. in the life sciences sector include the scientific and medical community French Scientific Research Centre to pursue pioneering research into (CNRS) and the French Alternative other diseases. Like other major Energies and Atomic Energy countries, biomedical research in Commission (CEA). France receives backing from a
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HEALTHCARE IS A KEY SECTOR IN FRANCE WITH ITS INDUSTRIES REPRESENTING*:
The French Federation of Healthcare Industries (FEFIS): 11 professional organisations that design, manufacture or distribute healthcare products.
▪ € 90 billion turnover
rd ▪ 3 largest export sector, with exports worth € 34 billion for the entire sector, i.e. 10% of France’s industrial exports (excluding energy and aeronautics)
▪ € 6.7 billion annual investment in R&D, i.e. approximately 20% of total French R&D spending across all sectors, not just healthcare
st ▪ 1 sector filing patents in Europe
▪ 2,700 Marketing Authorisations in the field of veterinary health
▪ 455,000 direct jobs (and related) across the entire sector, including 5% of direct jobs in the new digital healthcare economy
▪ 30,000 people dedicated to research, i.e. 15% of R&D personnel across all sectors, not just healthcare
▪ 6 % of French industrial employment
▪ A network of enterprises across the country, comprising multinationals, VSEs, SMEs and start-ups. 90% of medical devices and diagnostics companies are SMEs
* Rapport du CSIS 2014, et enquête interne à la FEFIS février 2017
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HUMAN AND VETERINARY MEDICINES, MEDICAL DEVICES, DIAGNOSTICS, MEDICAL TECHNOLOGIES AND BIOTECHNOLOGIES
▪ 1,400 companies which design, create, manufacture or distribute healthcare products for a wide variety of human and animal health applications; some 60 new biotechs are created each year.
▪ French biotech: 104 products currently in the clinical phases from a pipeline of 348 products ranging from proof-of-concept to marketing
HEALTHCARE ESTABLISHMENTS IN FRANCE*
▪ 2,694 healthcare establishments, including 35% public, 39% private and 26% private non-profit (e.g. the Comprehensive Cancer Centres)
▪ 655 hospital facilities for emergency treatment, 494 of which are public
▪ 102 emergency medical care coordination services (SAMUs) and 428 mobile emergency and resuscitation services (SMURs)
▪ 1,031 public establishments for people with disabilities
▪ 1,750 health centres** and 600 cross-disciplinary medical health centres (MSPs)***
▪ 331 telemedicine projects (renal or heart failure, chronic wounds, diabetes, etc.)
* Source: French Directorate General for Health Services (DGOS), 2015 edition. / ** Local practices staffed by various types of medical professionals and social workers, which support equal access to quality medical care. / *** Local practices, especially in areas of poor medical coverage, in which medical and paramedical professionals participate in social, health education and prevention actions and can share resources and split running costs.
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FRANCE, A LEADER IN THE LIFE SCIENCES
France has won recognition in publication excellence in the life and health sciences across the globe. Several French public research institutions are among Thomson Reuters 2016 Top Ten Global Innovators and the leading European health and biotechnology patent owners. The key to their success is bench-to-bedside research combined with top level hospital and university involvement.
A POLICY which include medicines, medical OF EXCELLENCE technologies, in vitro diagnostics, Aviesan, the French National eHealth and hospital organisation, Alliance for Life Sciences TO SERVE are becoming increasingly numerous, and Health, brings together HEALTH INNOVATION diversified and interdependent, while France’s main public and Innovation also comes from close the boundaries between them are academic life and health partnership between academic and becoming increasingly blurred. science stakeholders in order
industrial research. French research to define strategies for its France has already taken measures combines academic prowess, major main concerns. Innovation is to promote rapid access to certain industrial stakeholders and SMEs at the centre of each initiative innovations, which is typical of specialised in emerging products and supported by AVIESAN, with the country’s capacity to speed services. This is the French formula examples including the Cancer up access to innovative health for attracting talent, sustaining high Plan, the Neurodegenerative products. quality projects and changing the Diseases Plan, the 2025 France dynamics of innovative, personalised Healthcare innovation is a key Genomic Medicine Plan and medicine. public health issue. To add to the French National Healthcare the impetus of innovation in the Data System (SNDS) which is Safe, effective, useful and efficient field, the French government has part of the Big Data revolution. healthcare innovations for users appointed a Ministerial Delegate in France and beyond for Healthcare Innovation to Innovation in healthcare goes far coordinate the different sectors beyond innovation in medicine, involved so that public health will mainly because the fields concerned improve day on day.
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Opération chirurgicale à l’aide d’un robot
hospitals with the help of INSERM and GLOBALLY RECOGNISED RECOGNISED RESEARCH INSTITUTIONS the CNRS, have been exceptionally EXPERTISE dynamic in forming unprecedented Four of the world’s 25 most research partnerships in the life innovative public research sciences thus becoming a model in French public research institutions are French. This is translational research. 4 institutions among the world’s 25 according to the 2016 Reuters most innovative ranking, in which 1st place went to This unique continuum from the the French Alternative Energies and patient’s bedside to the industrial Atomic Energy Commission (CEA), optimisation of outcomes, benefits 6 world-renowned IHUs 5th place to the National Centre research at every step along the way. showcasing the effectiveness of the for Scientific Research (CNRS), French model: 10th place to the National Institute This specifically French approach • Paris: ICAN for cardiometabolism of Health and Medical Research in which everything starts with and nutrition disorders, Imagine (Inserm) and 17th place to the the patient and comes back to the for genetic diseases and Brain Pasteur Institute. This exceptional patient results in undeniable progress and Spine Institute which brings performance places France in pole in healthcare. Based on essential together France’s best teams in position for biomedical research interaction between physicians the neurosciences worldwide and highlights the power, and researchers, the organisational • Marseille: Méditerranée progress and innovations that it structure of French research makes Infection which responds to consistently generates. it easier to shed light on the most health crises Its leading position also reflects the fundamental of questions, translating • Strasbourg: IHU Mix-Surg which organisational structure of French them into progress that will improve is developing new generations research which it perfectly adapted the treatment of patients. of surgical instruments thanks to meeting new challenges. to medical imaging that supports The proximity of clinical investigation minimally-invasive procedures Within the past five years, six centres, laboratories and enterprise with considerably less risk of University Hospital Institutes (IHUs), forges links between their respective infection which are the cornerstones of teams, leading to the emergence of • Bordeaux: Liryc paves the way scientific cooperation, have become start-ups which in turn accelerate for new forms of assistance to global benchmarks. These institutes, medical innovation, the results of tackle cardiac electrical disorders established in French university which are turned into treatment.
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China, and North Africa are a long- standing tradition. Paris Descartes University has just signed an agreement to commence a new exchange programme with the Abulcasis International University of Health Sciences in Rabat in Morocco. Students from Rabat will do internships in Paris and in return teaching staff from Paris Descartes will give classes in Rabat. These agreements, which are not only academic but also logistic and financial, showcase French know- how in the teaching of medicine. French universities and their NEW MOMENTUM The health industries in France are prestigious educational teams are FROM PUBLIC-PRIVATE joining forces to propose solutions now also looking towards the Gulf to stakeholders worldwide. Their countries and Iran. Such high-quality PARTNERSHIPS association with the academic world exchanges can be developed with The number of published research provides a springboard for dynamic many countries who are aware of papers reflects the scientific development of the life sciences in the quality of the French medical excellence of French universities France. teaching model. The French teams and research organisations, regularly offer many classes in English, even recognised by international rankings. if the ability to speak French is The French Alliance for sometimes used as a qualitative Research and Innovation in filter to select students for training AMONG THE LEADERS, Health Industries (ARIIS), in France. The country’s Master PARTICULARLY IN THE LIFE which federates the healthcare programmes are greatly valued «SCIENCES, FRANCE IS ALSO DYNAMIC industries, has made it much in China, and entire education AT INDUSTRY LEVEL. easier to form public-private programmes based on the French partnerships. These partnerships or Anglo-Saxon model are offered have multiplied in recent years there. The incorporation of digital because international teams technologies and the use of interested in joint projects are simulation and modelling accelerate now able to find their French this research, which is increasingly THE SINGULARITY OF FRENCH counterparts more quickly. well-coordinated between the public MEDICAL EDUCATION LIES and private spheres. «IN THE ALLIANCE OF UNIVERSITY TEACHING, HIGH-QUALITY In addition, the French Alliance for RESEARCH AND MENTORED CLINICAL Research and Innovation in Health TRAINING. Industries (ARIIS) promotes closer ties within the private healthcare These synergies are fuelled by industries, which evaluate new the dual nature of the country’s therapeutic solutions and work on regional university hospitals (CHUs). cross-cutting initiatives. In this way, INTERNATIONAL Clinical training given by teacher- the sectors of medicines and medical practitioners is the predominant devices work together to propose PARTNERSHIPS BENEFIT feature of the second three-year turnkey solutions and simple and QUALITY TEACHING cycle of medical studies in France effective treatments especially in International partnerships between because students must complete 36 personalised medicine, where France French medical faculties and months of internship, as opposed to is at the cutting edge. universities in North America, 25 in Germany and 12 in Italy.
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GREAT BRITAIN NETHERLANDS
Lille BELGIUM English Channel GERMANY
PARIS
Strasbourg
Nantes FRANCE SWITZERLAND
Lyon Atlantic Ocean
Bordeaux ITALY
Montpellier Nice Toulouse Marseille
SPAIN Mediterranean Sea
Competitiveness Clusters dedicated to healthcare in France
IN FOCUS COMPETITIVENESS CLUSTERS personalised and precision medicine: MEDICEN PARIS REGION ARE THE ANSWER TO FUTURE biotechnologies, medical technologies and digital technologies. HEALTHCARE Medicen Paris Region, the Ile- de-France healthcare cluster, In 2004, within an increasingly is located on particularly fertile competitive global economy, France Within their respective territories, ground in a region that contains introduced a new industrial policy Atlanpôle Biothérapies, Alsace over half of the country’s life to mobilise the key factors of BioValley, Cancer Bio-Santé, science innovation stakeholders. competitiveness, with innovation Eurobiomed, LyonBiopôle, capacity at the top of the list. The Medicen Paris Region and NHL With over 250 members, Medicen various regional Competitiveness (Nutrition, Health, Longevity) has supported and accredited Clusters established for this purpose mobilise all those concerned numerous collaborative are a combination of companies, by innovation (SMEs, clinicians, innovation projects, including research centres and training academics and major companies) 270 funded by the State (Single organisations. Based on a partnership around a common ambition: Interministerial Fund, Bpifrance/ approach, the purpose of these innovation in the life sciences. Industrial Strategic Innovation, clusters is to generate synergies French National Research around joint innovative projects Agency, European Regional targeting one or more specific Within their respective territories, Development Fund, Invest for markets. The aim is to use these Atlanpôle Biothérapies, Alsace the Future Programme) and/or synergies and innovative collaborative BioValley, Cancer Bio-Santé, by local and regional authorities projects to propel the companies to Eurobiomed, LyonBiopôle, Medicen with a total investment of € 1.05 the forefront of their fields, both in Paris Region and NHL (Nutrition, billion (including € 471 million in France and abroad. Health, Longevity) mobilise all those concerned by innovation public aid) and has helped bring France has seven Competitiveness (SMEs, clinicians, academics and 49 new products to market in Clusters dedicated to the life sciences major companies) around a common the fields of imaging, medical which offer a consolidated response ambition: innovation in the life devices and biological solutions. to the challenges of tomorrow’s sciences.
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4 % 11,7 % Near and Africa Middle East 14,6 % Americas
11,9 % Asia
57,2 % 0,5 % Europe Others
French medicines exports by geographical zone in 2015 (Source: customs statistics)
FRENCH PHARMACEUTICALS: development of their activities using A HIGH PERFORMER France as a platform. AND MAJOR EXPORTER In an industry recognised by the The French pharmaceutical industry French government as strategic, the is evolving within an extremely G5 Health*companies are a major competitive international environment asset when it comes to healthcare and a strongly innovative and dynamic innovation and showcasing French context. scientific and The quality of its research, its highly- medical expertise qualified staff, its renowned industrial abroad. They have know-how and ability to adapt to made healthcare changing market needs have all research their made France the key player in global priority and are pharmaceutical production that it is the driving force THE FRENCH PHARMACEUTICAL today. behind quality INDUSTRY IN FIGURES Governed by stringent rules and public-private partnerships which procedures at each stage of the combine dynamic research companies production, distribution and export and strong academic research (Joint 224 production sites processes, and requiring highly- Research Units with French state- qualified personnel, French medicines owned organisations such as the 98,690 direct jobs meet the quality, efficacy and safety Alternative Energies and Atomic criteria required by the most exacting Energy Commission, the National € 4,565 million international standards. Institute of Health and Medical total enterprise investment Turnover in 2016: € 54.5 billion. Research and the major university in R&D hospitals, strong member-company Internationally-recognised involvement in the Competitiveness More than people 20,000 pharmaceutical and life sciences Clusters and Technological Research in R&D companies Institutes, etc.). This alliance G5 Health is a forum for the principal between academic research and Over € 25.8 billion in exports, French companies in the fields of healthcare enterprise creates the ideal generating a trade surplus of health and life sciences. These ecosystem for turning concepts into €7.6 billion companies have generated international concrete solutions for patients.
* BioMérieux, Guerbet, Ipsen, LFB, Pierre Fabre, Sanofi, Servier and Théa
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At their 33 R&D sites and 56 A professional production sites in France, the G5 With their many and varied organisation Health companies discover, develop fields of activity, their representing the and produce healthcare solutions for capacity for innovation industry: Leem the global market. and their longstanding The French Their fields of activity cover all international experience, pharmaceutical companies’ stages of patient management the G5 Health companies association (Leem) is the umbrella (prevention, diagnosis and are active exporters of organisation for 270 pharmaceutical treatment) and a vast spectrum healthcare solutions for companies, which account for 94% of innovative technologies the populations concerned of the industry’s turnover in France. (chemistry, molecular biology, and, in many cases, world Many of these companies operate biotherapies, vaccines, imaging, leaders. abroad from a platform in France. in vitro diagnosis and medical Leem is the industry’s voice in devices). They focus on many dealings with public authorities, health major pathologies (cardiovascular authorities, healthcare professionals and metabolic diseases, cancers, G5 HEALTH and patient associations. Its role also A HEAVYWEIGHT infectious diseases, brain ageing, GLOBAL PLAYER involves developing and enforcing neurologic diseases, autoimmune professional ethical standards thanks diseases, acquired and congenital to its Ethics Committee. haematological deficiencies) as well € 42.3 billion worldwide On the international level, the LEEM as rare diseases. sales encourages dialogue with the health authorities of the various countries in The G5 Health companies, in addition € 6.5 billion R&D order to move forward in areas such to their 56 production sites in France, expenditure i.e. 15.5% of as regulatory harmonisation, access have 116 production sites worldwide. worldwide sales to quality medicines and the fight Each site, which is always designed in against counterfeit medicines and respect of local quality standards and 150,000 direct jobs illegal trafficking. requirements (especially regulatory worldwide Leem also promotes exchanges and environmental), applies G5 between French and foreign Health’s renowned expertise and 116 production sites outside pharmaceutical companies in order to know-how in the production of France facilitate commercial, industrial and quality medicines, vaccines, diagnostic technological partnerships in France systems and healthcare solutions. 53 R&D sites outside France and many other countries.
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France at the global sites of the European pharmaceutical forefront of the vaccines companies produced 80% of the industry vaccines used in the world and exported 84% of their production, i.e. Vaccines have contributed to France’s 3.5 billion doses per year. reputation in the developing regions and countries for many decades. The In 2015, the export of vaccines spread of vaccination was fostered contributed € 1.2 billion to the by the discoveries of Louis Pasteur, French health products trade with the international network of balance. Pasteur Institutes playing a frontline role in distributing western vaccines and building public health systems at French excellence in local level. Nowadays, vaccination is vaccines research a strategic field of activity in which France has an extensive scientific France holds the leading position infrastructure in terms of vaccinology worldwide in terms of both R&D and and Lyonbiopôle is the first worldwide production. research ecosystem for infectious diseases and human and animal Louis Pasteur (1822 - 1895). French The two world leaders in human vaccines. biologist and chemist, particularly known for vaccines produce and invest his work on the rabies vaccine massively in their French production Lyon is a unique ecosystem, facilities, which have a production combining public research, world capacity of 1.3 billion doses and champions in vaccination and provide more than 5,500 industrial diagnostics, start-ups and small jobs in the field of vaccines. and medium biotechs innovating in the field of infectious diseases. At its domestic production sites, the The Gerland Biodistrict offers an French leader in the field has the exceptional concentration of players, world’s largest production capacity representing 5,000 private jobs in for the inactivated polio vaccine (IPV) health and biotechnologies, 2,750 and the world’s leading production researchers and the world’s first centre in the fight against seasonal private vaccines research cluster: and pandemic influenza with 140 Lyonbiopôle. million doses produced each year for Vaccination reduces child both hemispheres (thus meeting the mortality, particularly in the needs of the entire world). It also During the Decade of developing countries. manufactures the first dengue fever Vaccines (2011 and 2020) According to the WHO, vaccine, which has already been endorsed by the WHO, vaccinating 90% of children registered in a number of endemic vaccination against six against 14 diseases (diphtheria, zones, notably Mexico, Philippines and diseases (pneumococcal disease, Hib infection, whooping cough, tetanus, Brazil. measles, polio, tuberculosis, rotavirus diarrhoea, whooping hepatitis B, Hib infection, An export-oriented cough, measles and malaria), rubella, meningococcal and vaccines industry could save 6.4 million lives, avoid 426 million cases of pneumococcal diseases, rotavirus At present, France exports 85% of disease, save $ 6.2 billion in and, in endemic areas, Japanese its vaccines production. France and treatment costs and $ 145 encephalitis and yellow fever) Europe hold a prominent place in billion in loss of productivity could save the lives of two the export of vaccines abroad, the in the 72 countries supported million children under the age of marketplace for most of the doses by GAVI*. five each year. they produce. In 2013, the production
* International organisation aiming to improve access to new and underused vaccines for children living in the world’s poorest countries
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Vaccination: incomparably cost-effective Vaccination is considered the most cost-effective health intervention following water quality. In addition to improving life expectancy, it enables public authorities to make savings. Indeed, treating a patient already affected by a disease, even benign, generally costs one hundred times more than vaccination would have in the first place.
According to the World Bank, improving health contributes to economic growth by reducing the incidence of worker morbidity, making it possible to use natural resources in pathogen-infested areas, increasing school attendance and assimilation rates and freeing up resources that would have been used to treat the diseases concerned.
Veterinary medicines and reagents France is the European leader in the research and manufacture of veterinary medicines and reagents, employing over 6,700 people and possessing the largest therapeutic arsenal in Europe (2,700 Marketing Authorisations).
The French Association of Animal Health Industry (SIMV) has 40 member companies employing 6,700 people. Four French companies are ranked among the Top 10 in this sector worldwide. Two-thirds of the products manufactured at its members’ 50 French production sites are exported, which represents € 1.2 billion.
France’s competitiveness in terms of animal health lies in the density of its industrial, veterinary and professional fabric, in its recognised scientific and technical expertise and in the capacity of its manufacturers to invest in managing networked R&D projects and international projects.
Since infectious diseases can be transmitted within species in many different ways, close collaboration is needed between animal health, human health and the environment.
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FRANCE, ESTABLISHMENTS AND PRODUCTS SERVING CUTTING-EDGE MEDICINE
France’s network of 2,800 local, tertiary referral and university hospitals provides equal access to health services to the entire population. The staff provide the best possible individually-tailored care without judgement or discrimination while optimising resources and thus contributing to the ongoing quality of its public health system.
Treatment, research and teaching are closely interwoven in the French healthcare system, bringing sophisticated tools and technological innovation to each patient, tailored to their needs. High quality treatment is the result of university-hospital based training of personnel at the cutting edge of international scientific knowledge, innovative advanced technology, multidisciplinarity and a global vision of the patient, combined with private community outpatient medicine. It is to France’s credit that it has built one of the world’s best healthcare systems, something that is regularly reflected in population satisfaction surveys. Recognition also comes from further afield witnessed by the May 2016 special issue of The Lancet, devoted to French healthcare. New personalised healthcare approaches also mean Institute of Cancer Research in Western France (ICO), Nantes that treatment can be targeted according to the pathology and certification every four years to this excellence is also based on the person’s context. Optimal care ensure that their procedures and integrated offerings in terms of pathways are developed from the professional practices meet quality public health and management. It first very signs of illness to include criteria. An equally essential role is a solution endorsed by everyone all the healthcare and social factors is played by the country’s health concerned - industrial and involved. safety agencies, which work to commercial companies, research ensure optimal quality of healthcare. consultancies, hospitals and Patient outcome is not the only research centres, with the support consideration. France has a quality Lastly, France has a leading of the public authorities – to better control system, overseen by its pharmaceutical and vaccines meet the health and healthcare National Health Authority (HAS). For industry. expectations of the international more than 20 years now, public and community and all of France’s private healthcare establishments In response to the requirements foreign partners keen to benefit have been required to undergo of the population and society, from its extensive know-how.
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French private hospitals already have HEALTHCARE ESTABLISHMENT UNICANCER STRONGLY INVOLVED international experience acquired IN FIGURES through inter-hospital cooperation and the development of affiliates and 20 centres dedicated to cancer networks. The private sector intends to continue to promote the French 18,000 employees France’s public hospitals account healthcare system by placing its recognised know-how at the service € 2.1employees for 65% of short-stay activity, 52% of conventional surgery, 32% of of international stakeholders. Over 300 clinical trials ongoing outpatient surgery, 82% of medical activity, 40% of aftercare and UNICANCER is the Over 120,000 patients rehabilitation, 70% of psychiatric umbrella organisation hospitalised each year activity and 83% of emergency for all the French treatment. Comprehensive Cancer Centres (FCCCs): these private non-profit health establishments are exclusively devoted to treatment, research and teaching in oncology. A Federation of Private Well-organised private hospitals: truly French concept, the FCCCs are Non-Profit Hospitals 1,000 private hospitals in present throughout the country. They The French Federation of Private France annually account for 8.5 strongly contribute to the excellence Non-Profit Hospital and Social million patients, 57% of surgical of French healthcare in the treatment Care Establishments (FEHAP) is procedures, nearly 68% of of cancer. Many of UNICANCER’s the reference federation for the outpatient surgery, one in four innovations and proposals have been private non-profit sector and has births, nearly one-third of aftercare used in French cancer plans and then been present in every field of social and rehabilitation and more than extended to include all healthcare welfare since its creation in 1936. 17% of psychiatric hospitalisations. establishments. Private non-profit establishments Their expertise is recognised by and services combine a public the French public authorities. service mission with a private mode of management, and work in the With its national experience Alone or in association with other interests of social utility and the built on the excellence healthcare establishments they common good. Their missions are of its practices and operate: to guarantee access to healthcare, its organisational and • 15 out of 24 geriatric oncology treatment and support for everyone management know-how, the units, and to ensure the lifelong continuity private hospitals sector has • 6 out of 8 centres for adolescents of care and treatment of all much exportable expertise: and young adults, pathologies, handicaps and loss of • Construction from the • 8 FCCCs are coordinators for autonomy. ground up and management rare forms of cancer out of 17 In figures, the FEHAP represents of healthcare establishments healthcare establishments identified some 4200 health, social and • Training of hospital teams in France, medical-social establishments and to pass on skills acquired in • 2 trials out of 5 for the ‘personalised services run by more than 1600 specific practices post-cancer programme’. managing bodies (associations, • Advice on healthcare Their expertise is recognised by the foundations, congregations, provision, hospital financial French public authorities. Alone or non-profit complementary resource management, in association with other healthcare health insurance companies, establishment of efficient establishments they operate: complementary-pension and life risks governance, improvement • training of healthcare professionals, funds [incapacity/invalidity/death of patient care pathways, • scientific partnerships, coverage]), more than 246,600 beds/ medical projects, quality and • assistance with opening oncology places, and 230,000 professionals safety of care, etc. centres and services, inspired by for 2.5 million people accommodated the FCCC model. each year.
* Source: French Hospitals Federation (FHF)
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to remain at home. • Economic, with the need to better A few examples of countries allocate funds, particularly public that have benefited from funds, avoiding hospital stays when French expertise: they are not absolutely necessary • Vietnam (Hanoï University (although local technical platforms Hospital): French Cooperation and ongoing monitoring would be Agency for Health Care needed instead). Services Development (ACODESS) and Paris Public The FNEHAD, which federates 240 Hospitals Group (AP-HP) establishments of all types (public, • Morocco (countrywide private and private non-profit) and hospital modernisation plan): accounts for more than 90% of at- Sofreco, Antarès Consulting home hospitalisation time, is devoted • Abu Dhabi (Cleveland Clinic): to promoting and developing this Oger International, Leader form of healthcare, which for the Health present is underutilised in France. • China (Beijing’s Xie-Hie Hospital, Zhuhai’s Mother AT THE SERVICE OF DIGITAL and Child Centre, Huzhou’s HOSPITAL DESIGN AND General Hospital): AIA and CONSTRUCTION associates. The financial constraints involved in the renovation or construction Through the creation of of hospitals mean that strategic consortiums of major companies Hospital at Home (HaH) is a specific decisions must be based on to conduct design, build & form of management in which the organisational models that are tried maintenance projects and through quality of hospital care is combined and tested in terms of healthcare the provision of funding in various with the comforts of home. quality and cost-effectiveness while legal forms where necessary, With over 300 establishments across incorporating the latest Information France offers not only an the country, HaH in 2015 accounted and Communication Technologies architectural context that takes for 105,000 patients, 4.6 million (ICT). the identity of each project into days and provided comprehensive consideration but also an operating and coordinated multidisciplinary With the experience acquired from framework that can be adapted to medical, nursing and psychosocial the design and construction of the culture of each country and care to patients with serious, acute the ten hospitals built in recent includes the most recent biomedical or chronic diseases. years, France is well-placed to and IT technologies. offer solutions for the effective This specific know-how in the organisation of many hospital France offers a panel of digital evaluation and coordination of processes, whether medical, medical- solutions for each of the processes healthcare makes HaH an essential technical, logistic or housekeeping- involved in running a hospital. response to the challenges posed to related. France has all the expertise Based on two major principles, the French healthcare system (and an and know-how required to optimally namely the IP multimedia network interesting experiment for many other structure healthcare provision across and the nationally shared electronic countries facing the same challenges), a given territory, as well as to deliver patient record, IT solutions namely: turnkey hospitals designed to satisfy evaluated by experts for their • Demographic and epidemiological, patient needs first and foremost, return-on-investment value, can with population ageing and the taking into account their individuality be proposed for each of the four increasing proportion of people and the new possibilities offered components of a digital hospital with chronic diseases. by a more personalised form of that correspond to the international • Societal, with patients and their healthcare. state-of-the-art: the connected relatives increasingly wanting them hospital, the robot-assisted
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automated hospital, the smart France does not simply turn out of hospitals, procurement, training building and the eco-hospital. solutions in cookie-cutter fashion (medical, paramedical, technical - as is the wont of American and and management staff) with the Using the services of a lead European competitors - but delivers guarantee of top quality and contractor to deliver a turnkey modern adaptable architectural high-level skills. The aim is to solution means freedom to aim packages that enable digital provide clients with the analyses for excellence across the board: organisations to adjust their offering and technical documents need to user eHealth, telemedicine, use of to the medical and managerial make the best decisions in terms digital simulation in staff training, culture of the client country. of the design, building, renovation, geolocation of people and property, rehabilitation and equipment of paperless offices, programmed care hospitals pathways, autonomous outpatient FOR ORGANISATION AND circuits, hybrid operating rooms, EFFICACY, THE FRENCH robot-assisted operating rooms, HEALTHCARE SYSTEM IS OFTEN networks to access digital imaging, « CONSIDERED ONE OF THE WORLD’S integrated and automated medicine BEST PERFORMERS. circuits, integrated and automated biology platforms, multiservice bedside terminals, decentralised Due to the changing needs of the dynamic storage, automated and population, the fluctuating political robot-assisted handling, pneumatic and economic context and advances waste transport, high environmental in science and technology, the quality of buildings and French healthcare system has been infrastructure, centralised technical constantly debated, discussed, building management interfaced with challenged, reviewed and adjusted maintenance management, digital over the decades. The two major modelling of buildings, etc. issues are always involved: how to improve access to treatment and More generally speaking, at the how to reduce costs. programming stage, France is able to propose an organisational design IMPE, the French leader in the that is both medical and logistic, provision of turnkey hospitals and the result of a tried and tested the other companies in the sector methodology which involves all the actively participate in these debates local players. The impact on the and contribute to the improvement architecture of the organisational of healthcare systems by developing choices made by the client is then innovative solutions to meet the taken into account in the conceptual requirements of the emerging design in which digital simulation countries concerned. tools are used to model flow and volume. The technical definition Their experience on the international and scheduling phase calls on scene, illustrated recently when the world-renowned know-how IMPE was awarded the contract of the major French construction for the Can Tho Hospital in companies, the most reputed Vietnam, enriches the debate architects with experience of other and drives the export of French countries, major construction and fields of excellence: hospital computer engineering companies, infrastructure, information systems, consultancies specialising in the medical devices and equipment, management of complex projects expertise, consulting, regional and so on. strategic planning, engineering, construction, programming, running
* Ideal Medical Products Engineering (IMPE)
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A VIEW At the service of cutting- fields. In my specialty, haematology, edge medicine biological research is now well- FROM THE integrated in clinical research. This FIELD Universal access to healthcare is very interesting model is one of the ELIANE GLUCKMANN, undeniably one of France’s greatest solutions that we must share with Emeritus Professor who assets and the inspiration of other others. performed the first ever umbilical healthcare systems. Many do not cord blood transplantation in 1988 possess our experience in the field Hereditary diseases and biology: and numerous countries today French teams always at the top are attempting to emulate our In haematology and cell and gene healthcare model. therapy, we are historically the leaders in clinical research in a On the professional level, the field that I know well. This French excellence of our training in terms leadership has meant that we of research and clinical practice are ahead of other countries in produces undeniable skills. Ours paediatric hereditary diseases, is the country of Professor Jean helped by the performance of an Dausset, winner of a Nobel Prize for increasing number of umbilical his discovery of the HLA system, cord blood transplantations, a Professor Jean Bernard, pioneering field in which I have published haematologist and founder of an over 850 articles in the most internationally-renowned school prestigious international journals. of thought in haematology, and While publication makes it possible Professor Jean Hamburger, pioneer to share scientific advances, we in the field of kidney transplants. can go much further than that. We They invented the university- cannot keep our discoveries to hospital model in which ongoing ties ourselves and the development of between hospitals and research are our teams on the international level forged. has been natural and spontaneous.
This is not the case everywhere and the synergies generated by THE CHALLENGE IS TO ADAPT the country’s university hospitals TO LOCAL CONDITIONS, are an important asset reflected «SOMETHING THAT THE FRENCH in the number of international TEAMS DO WITH GREAT SKILL. THE publications by French research FRENCH MODEL IS ADAPTABLE, teams, long considered to be among IT IS OUR OBJECTIVE AND OUR the leaders in their fields. More STRENGTH. » and more young French doctors are opting to spread their knowledge beyond our borders, and are highly In terms of innovative treatments, appreciated wherever they go. French solutions are very quick to The French physicians who are spread beyond our borders. Our members of this international elite teams have many solutions in the are reputed for developing cutting- pipeline that are of interest to the edge medicine which brings new entire world. Both in transplantation solutions to the four corners of or genomics, not to mention the world. We have brilliant teams advances in molecular biology, that are highly reputed in many leading French teams are ready to
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share their discoveries. The new molecules derived from research are rapidly becoming essential. Cell and gene therapy, particularly in haemoglobin disorders, are areas in which France is particularly strong and can further share its knowledge. It is totally new and the French teams are very much ahead in this field. Our knowledge of umbilical cord blood has propelled us to the global forefront. As I speak, we are conducting highly promising research into genetic diseases of haemoglobin related to sickle-cell anaemia.
OUR GOAL IS TO ESTABLISH CENTRES OF EXCELLENCE «THROUGHOUT THE WORLD. »
The challenge does not only lie in exporting our knowledge to developed countries but also to developing countries. With centres of reference being set up in the subtropical countries, French teams are bringing new solutions to Africa, Brazil and other emerging countries. In sickle-cell anaemia, a pathology classed by the WHO as being a major public health concern, our solutions are also eagerly awaited in the United States and South America. The aim is to structure healthcare, from diagnosis to treatment, by sharing the possibilities that gene therapy offers. Today, our knowledge coupled with expertise in healthcare organisation is crossing national borders to provide the most comprehensive and human response possible from a technical viewpoint.
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Efficient systems to assist At the service of ageing dependents ageing dependents France Silver Éco, an association of public and When it comes to assisting Silver Économie is a neologism that private sector service ageing dependents, France appeared in the official vocabulary providers, was established has developed an efficient in 2013 when Arnaud Montebourg in 2014 to promote the system divided up between and Michèle Delaunay, respectively cause of a Silver Économie, the public and private sector French Minister of Industrial Renewal and associations. At present, source of growth, jobs and and French Minister Delegate with 560,000 people reside innovation at home and responsibility for the Elderly at in 7,000 establishments abroad. the time, created a Silver Economy assisted by 330,000 specialist industrial sector with its accompanying professionals. With their committee, responsible in turn for recognised expertise in the respecting an industrial sector contract. field, French private companies are considered to be among Ensuring that technological and digital the leaders of the sector at advances improve the daily lives However, the Silver Economy has a European and even global level. of increasingly-dependent seniors second dimension, which corresponds Now established in Belgium, is a challenge for which there are to the efforts made by economic Czech Republic, Germany, currently a number of solutions. stakeholders to adapt to their ageing Italy, Poland, Quebec and Fall detectors, automatic pathway consumers and thus broaden the Spain, these companies are at lighting, adjustable-height furniture, range of what they can offer. For the forefront in the emerging connected pillboxes, health monitoring example, banks can offer reverse markets, especially Asia with apps, so-called “serious games” mortgages, the transport industry the recent inauguration of their used to prevent memory loss and can offer mobility solutions, builders first establishment in China. systems such as Skype, which are can adapt accommodation, elected used to stay in contact with children To showcase the country’s representatives can rethink town know-how and stimulate and grandchildren, are all part of the planning, insurance companies can innovation, France launched technological progress that contributes provide specific complementary health its Silver Économie industrial to a better anticipation and facilitation insurance and dieticians can provide sector in 2013. The innovation of the ageing process. nutritional advice. concerns both technology and the creation of a type of elderly care coordination, called the Parcours de la Personne âgée, in which each person, upon reaching retirement, can choose the type of accommodation, services and assistance best suited to their needs, wishes and pocket. Solutions include home care services, retirement communities (Résidences Services Seniors) and nursing home care (EHPADs). The Parcours de la Personne âgée ensures fluid transition between each stage in the life of the elderly person and consistent coordination between stakeholders to contribute to ageing well under the best conditions.
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MEDICAL TECHNOLOGIES: particularly due to innovations and A DYNAMIC FRENCH INDUSTRY the development of eHealth.
France: at the forefront ▪ France, known for its excellence in in medical devices healthcare: major R&D collaborative potential thanks to university hospital laboratories and major research ▪ 4 th leader worldwide and 2nd in Europe. A market evaluated at organisations (CEA, CNRS, INRIA, € 20 billion. Inserm, etc.); 76% of companies in the field have R&D activities. ▪ More than 1,000 medical % MANY WORLDWIDE FIRSTS device manufacturers, 94% of which ▪ Approximately 6 of turnover ACHIEVED IN FRANCE are SMEs (with 45% VSEs and 2% invested in R&D by medical device middle-market). Spread across the companies established in France with st entire country (75% can be found research and/or production activities. ▪ 1 total hip replacement without cement (1970) in the regions of Ile-de-France and Rhône-Alpes). ▪ 1 in 3 orthopaedic implants is st ▪ 1 implanted insulin pump (1981) made in France. st ▪ Many French middle-market ▪ 1 coronary stent (1986) companies at the cutting edge of ▪ France ranks 5th for the number of st medical devices both in France European and international patents ▪ 1 computer-assisted open and abroad (contrast media, filed and represents10 % of the heart surgery (1998) heart valves, orthoses, infusion patents filed in Europe. In the medical st equipment, wound care). devices sector alone, more than ▪ 1 use of an artificialpancreas (2011) patents are filed in France ▪ 65,000 jobs in France. 600 each year, i.e. per day. st 1.6 ▪ 1 implanted artificial heart
▪ Strong development potential, (2013)…
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MEDTECH IN FRANCE WHAT IS A MEDTECH?
Medtech In France. The French champions of medical devices. France has over fifty medtechs,
all members of the association Artificial heart created by the company CARMAT MedTech in France, whose aim is to a driving force in the France: in pole position It has taken 25 years of research French innovative technologies in artificial organs to create an artificial heart*, the first sector. of which was implanted in a patient The quest for artificial organs began at the end of 2013. Offering a real at the end of the 19th century, with Among these companies that alternative to transplantation, this attempts to develop “breathing are revolutionising healthcare technological feat is an innovation that machines”, capable of replacing are innovative companies in is 100% French. This artificial “smart deficient lungs. The challenge today is the fields of artificial hearts, heart” capable of fully reproducing the obviously enormous: solutions must be artificial retinas, optic biopsies, physiology of an actual human heart found as quickly as possible to save the ultrasound treatment of contains sensors supplying information patients awaiting transplantation, given tumours, low-dose X-ray that makes it possible to adapt to the shortage of organ donation (there imaging, stents, technologies variations in activity. It is the result of is a shortage of over 12,000 organs used in spinal surgery, robotics synergies between medical know-how each year for people awaiting heart, and innovative telemedicine and engineering in biomaterials, micro- kidney, liver or lung transplants) and solutions. mechanics, hydraulics, electronics, etc. the risk of rejection.
These innovations produced by France has also been a pioneer in the French medical research are development of an artificial pancreas, already recognised throughout Each year in France patients developed by Diabeloop. A true the world - over 90% of the are fitted with more than: ‘pancreas 2.0’, intelligent and perfectly turnover of these medtechs is • 1,200 thoracic aortic stent autonomous, it is capable of measuring generated abroad. grafts blood glucose and directly controlling • 7,000 abdominal aortic stent the pump that will deliver the correct They will have a triple impact: a grafts dose of insulin to the patient. This medical impact on the patient, • 15,000 implantable represents an immense hope in terms an industrial and economic cardioverter-defibrillators of autonomy, safety and quality of life impact on the country and an • 25,000 heart valves for patients with diabetes and could organisational impact on the begin to be marketed in Europe at the healthcare system. end of 2017.
* CARMAT
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SNITEM: a professional organisation project, prosthetics and the treatment representative of the sector of diabetic foot. All of these are Set up in 1987, SNITEM (French exportable innovations. trade association of medical devices) is the first professional organisation The medical imaging to represent a majority of the medical industry device and the Healthcare Information Medical imaging is a medical specialty and Communication Technology designed to orient and confirm (Healthcare ICT) industries. It has 400 diagnosis and/or guide therapeutic members, many of which are SMEs. procedures. It is a key discipline used by many other specialties. It is An example of an also highly innovative and will play integrated offering: a major role in the development diabetes of preventive and personalised In 2030, it is estimated that 550 medicine. Beyond its traditional million people, particularly in the USA, uses in diagnosis and therapeutic India and China, will have diabetes, monitoring, it is also entering the field a disease that can lead to foot of treatment, such as interventional ulceration and possible amputation. radiology, using techniques that are A programme called AKEOME is less invasive than those of traditional currently being conducted by a surgery. In addition, it is a potential French company focusing on the source of cost reduction, particularly healing of diabetic foot ulcers, a in hospitalisation expenses. pathology for which no product in Since its invention at the end of Diabetic insulin pump the world has yet demonstrated real the 19th century, medical imaging clinical efficacy. This € 50 million has contributed actively to medical programme received the support of progress. During the second half of Bpifrance in 2016. the 20th century, medical imaging IN FOCUS FRANCE’S PRODUCTS techniques diversified and currently France has several frontline AND TECHNOLOGIES players in the field of diabetic cover radiography and CT scanning, medical technologies: blood glucose MRI, ultrasound and nuclear medicine. In France, some 250 companies measurement, the artificial pancreas MRI, ultrasound and nuclear medicine. make up the fabric of the medical imaging sector, employing approximately 40,000 people. The majority of these companies focus on X-ray, MRI or light-wave methods. One of them, among the sector’s four world leaders, has research and production facilities in France and sells a comprehensive range of products across the globe, including contrast media for X-ray, MRI imaging and interventional, and the corresponding injectable solutions. A world leader in imaging equipment is also firmly established in France.
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eHealth: recognised on the international level, Diagnostics: a dynamic a rapid-growth sector widespread use of digital solutions industry for quicker and within the population and in The French digital health industry safer treatment healthcare processes. Major national is a dynamic sector representing The companies that form the in projects (particularly the Carte Vitale 30,000 jobs and a € 3 billion vitro diagnostics industry design, electronic insurance card, shared market. It includes companies that develop, manufacture and market patient medical records and shared provide long-established solutions the tools, reagents and databases patient pharmaceutical files). (such as hospital information used to analyse and obtain Several recent initiatives support systems and software for health information about the patient from the sector’s strong development, professionals), as well as start-ups, samples of biological fluids. including the publication in July SMEs and major groups positioned 2016 by the French government in more recent sectors of activity of its strategic roadmap for the which are currently experiencing A key link in the healthcare development of eHealth between major development (especially chain now and 2020. connected objects and mobile 60 to 70% of medical decisions health applications, telemedicine are based on the results of in solutions and treatment coordination vitro diagnosis. platforms). The figure rises to 80% for decisions made in the hospital France has all the assets and environment. In October 2015, the companies advantages needed to sustainably supplying eHealth solutions formed play a leading role in this sector an umbrella association, via their and provide the population with The in vitro diagnostics industries professional organisations, called access to high added-value eHealth form a major sector of the French Alliance eHealth France, to work services: cutting-edge industrial economy. They include national towards developing the sector and solutions often co-developed champions on the worldwide scale promoting it in France and abroad. with medical teams of excellence and have a strong capacity for innovation.
In a context of controlled health spending and attractive markets in emerging countries, the sector has successfully adapted its offering, its organisation and the skills of its employees, whose level of training is one of the highest in the industry.
Performed in public and private centralised laboratories, medical practices or by the patients themselves, biomedical analysis has benefited in recent years from scientific progress in terms of biological systems and the pathophysiology of diseases.
Telemedicine booth
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• the emergence of new analysis and communication technologies that reduce analysis times and even allow real-time and long- term monitoring using embedded sensors (high-throughput sequencing, mass spectrometry, point-of-care tests, microfluidics, nanotechnology, automation, wireless communication, embedded microsystems and microsensors, communication by telephone operator, etc.), • the expectations raised by the analysis of humans through systematic biological approaches (genomics, metabolomic proteomics, etc.) and bioinformatics (in silico biology, systems biology, etc.).
France has the second largest number of in vitro diagnostics producers in Europe. These producers play a major role in providing reagents to deal with the appearance of emerging diseases. Three months after the Ebola crisis occurred in Western Africa, a French SME was able to offer a simple, rapid screening test thereby helping to contain the epidemic.
THE GLOBAL IN VITRO DIAGNOSTICS MARKET There are about one hundred 80% of their turnover through export. IN FIGURES French companies dedicated to this In the reagents segment alone, the French in vitro diagnostics industry sector. Just over a third of them % billion, i.e. of have development and production contributes € 1.5 billion to the trade ▪ € 50 5 the world healthcare market balance. facilities in France. (pharmacy, medical devices, in The in vitro diagnostics industry These companies which include vitro diagnosis). several major manufacturers of world represents approximately 12,000 renown and a number of successful direct jobs in France and over 60,000 ▪ The European market (34% of the SMEs, which represent 90% of the indirect jobs. world market) is the second largest, sector, produce 7,000 out of the not far behind North America (43% 40,000 in vitro diagnostic devices Strong potential for future of the world market) produced in Europe, making France development in this field, thanks to: the second largest producer in • its ability to fundamentally change ▪ The French domestic market Europe. These companies reinvest medical practices and their cost, represents 4.5% of the world 11% of their turnover in R&D. • the unique and essential position it market and 17% of the European occupies between clinical practice market with an estimated value of The French manufacturers generate and clinical research, € 1.8 billion.
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THE FRENCH MODEL: UNIVERSAL ACCESS TO HEALTHCARE
France has established a world reputation for exceptionally high quality healthcare and life expectancy. The cost-effectiveness of its healthcare is also one of the best in the world. Although the price control system is very patient-oriented, the industry remains competitive. Considerable importance is attached to the pertinence of medical and surgical procedures and to the economic performance of management.
Irrespective of a country’s health insurance system, France can provide concrete solutions for building relevant, efficient health insurance schemes. France has successfully met the challenge of providing universal healthcare while balancing the budget.
UNIVERSAL HEALTHCARE excessive increases while preserving This liberal approach to access to BASED ON SOLIDARITY the investment capacities of the private or public facilities and to the healthcare providers. As a result, entire healthcare profession under The French health insurance model the out-of-pocket expenditure of very acceptable financial conditions is based first and foremost on public French households is among the is one of the characteristics of the health insurance that is shared lowest in the world, while the level French system that has contributed by the entire population. French of quality of healthcare is very high to its success. social security plays a major role and its accessibility is exceptional. in ensuring the nationwide sharing In addition to universal public of resources and funding, by In terms of access to treatment, health insurance, the French guaranteeing coverage of the major the French system, which is very system also comprises private health risks. This is the most efficient open, is based on the patient’s complementary health insurance, way of ensuring equal access to freedom to choose between public which is very widespread. It offers healthcare across the country. and private healthcare facilities and a fair compromise between the also to choose their own primary- need for healthcare operators For hospital care and medicines, care physician. In return, private and insurers to make a profit and the various health insurance funds practitioners accept the regulation the quality and affordability of and the State control the price of their fees, which are usually the treatment. of healthcare in order to avoid subject of negotiation.
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AN ORIGINAL COMBINATION insurance systems which can thus operation, particularly in Algeria, OF COMPULSORY AND securely exchange data. Azerbaijan, France, Gabon, Germany, Italy, Slovenia and Sweden. COMPLEMENTARY HEALTH Payments and reimbursements are INSURANCE electronic. Thanks to paperless ADMINISTRATIVE In France, compulsory public health invoices and claim forms, the patient insurance currently covers about reimbursement process has become MODERNISATION OF THE 75% of total healthcare costs while extremely efficient. Soon, theCarte HEALTH SYSTEMS complementary insurance covers Vitale will provide patients with When streamlining administrative 15%. The remaining 10% is paid by direct access to their compulsory and tasks, particularly by reducing patients, which, on the whole, allows complementary healthcare coverage the number of intermediate steps, them to access quality healthcare at in real time and enable health it is not enough to introduce reasonable prices. This combination professionals to identify card holders. paperless transactions. Access to of compulsory and complementary The widespread use of the card will healthcare, patient registration and solutions may seem somewhat provide on-line access to coverage reimbursement must also be made original. and perfect synchronisation of data easier. flow. In the event of major or chronic The next stage in restructuring illness, treatment is fully covered by the relationship between patients, compulsory public health insurance, SECURE NATIONAL healthcare professionals and public while more routine healthcare, HEALTHCARE PROGRAMMES sector representatives is clearly the which is partially funded by A leader in the field of digital introduction of digital transaction complementary private insurance, security, Gemalto participates in technologies and the creation of still remains very accessible. This over 100 government programmes. electronic health cards. societal choice in France is quite Its experts contribute to national unusual and represents a departure discussions on how to improve IT from traditional models in which the systems, particularly in terms of public and private sectors are strictly preventing fraud and reducing errors. segmented. The French model is more nuanced and guarantees more With a 2015 turnover of € 3.1 billion freedom of choice in the event of ill and more than 14,000 employees, health. By complementing each other Gemalto provides its public and (and sometimes competing with each governmental partners with the other), public and private healthcare assistance, information and the With these cards, healthcare insurers work together innovatively. means needed to successfully professionals can access a Access to the private hospital sector upgrade their organisations and patient’s administrative and medical always remains possible, without processes. information anytime anywhere, distinction. thereby eliminating the risks related to emergency situations and For 20 years, Gemalto has been optimising the quality of services. providing efficient solutions to A TECHNICALLY INNOVATIVE This technology makes it possible protect: MANAGEMENT SYSTEM to improve healthcare systems over • the identity of users To facilitate the exchange of data, the long term, as well as combat through identification and France has for the past 15 years fraud, corruption and cheating the authentication, been using the Carte Vitale electronic system. Fraud in healthcare and • the personal data of users insurance card system, which is a social security systems is a growing through data encryption, particularly innovative. The Carte concern worldwide because it • transactions Vitale is a smart card designed to threatens their sustainability. instantly identify patients being treated by healthcare practitioners Gemalto has provided technical Studies conducted by the European and whose healthcare is covered solutions for 11 national eHealth Healthcare Fraud and Corruption by compulsory and complementary systems that are currently in Network (EHFCN) show that the strong identification of patients and
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healthcare professionals is a major emphasis on human resources in factor in overcoming these problems: health). ‘The key message is first of all the need for strong identification, in In the context of international order to answer the question “who and French universal healthcare is paying for whom and for what?”. coverage, the agency is developing This will result is more rational specific projects on healthcare health spending, easier checks and funding and access to treatment. subsequently a more sustainable social security system. It would be delusional to believe that healthcare Founded in January 2015, can remain anonymous.’ The Algerian Expertise France National Fund for Social Security for • Contributes to sustainable, Salaried Workers (CNAS). inclusive and mutually- EXPERTISE FRANCE supportive development, mainly WHAT DOES IT MEAN? EXPERTISE FRANCE: by reinforcing partner-country FRENCH EXPERTS SERVING public policy quality. INTERNATIONAL COOPERATION • Builds the capacities of its Expertise France, the French partners in terms of defining International Technical To contribute to the capacity and implementing public policy Assistance Agency, is the building of its partner countries, suited to the needs of the country’s public agency France’s reference public agency populations concerned. The for international technical for international technical agency thereby contributes cooperation, working closely with cooperation. to implementing French these countries in a joint approach, Expertise France has four foreign policy objectives of designs, develops and implements priorities: democratic, economic development cooperation, development cooperation projects and financial governance; influence and economic and programmes, particularly in the diplomacy. stability and security of field of healthcare. countries in states of crisis or post-crisis; sustainable urban development and the Inter-hospital cooperation is a fight against climate change; form of sustainable intervention THE CREATION AND recognised as contributing to reinforcement of healthcare IMPLEMENTATION OF the achievement of healthcare systems, social protection and DEVELOPMENT COOPERATION « objectives. It involves training local employment. In these various PROJECTS, FOCUSED ON THE staff in primary-care facilities and fields, Expertise France develops TRANSFER OF KNOW-HOW BETWEEN community organisations as well as and implements capacity- PROFESSIONALS. high-level specialists in university building projects, mobilises hospitals. It helps to address needs technical expertise and oversees Priority to reinforcing in terms of prison healthcare, turnkey projects combining healthcare drug addiction, kidney transplants, public expertise and private Expertise France aims to reinforce interventional cardiology, hospital know-how. With a volume of the capacity of its partner countries hygiene and the management of operations of € 115 million, to pursue healthcare policies that are medicines. over 400 projects carried out in both sustainable and efficient. The 80 countries and 63,000 man- agency prioritises cross-cutting Developing integrated health days of expertise provided in healthcare system reinforcement projects is also one of the 2015, Expertise France reflects of all components (service provision, agency’s priorities. In Côte d’Ivoire, Congo and Mali, Expertise the French policy of solidarity, health-product management and France, together with the French influence and economic procurement, health information School of Public Health (EHESP), is diplomacy. systems and governance, with the
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reinforcing hospital governance: Other Expertise France from training hospital directors to activities in healthcare: aiding hospital reform. In Tunisia, • Projects focused on sexual, Expertise France is accompanying reproductive, maternal, neonatal a project to build a hospital and and infant health development, include it in the existing healthcare a priority objective of Expertise environment. France. The fight against addiction (drugs A key player in the • in Senegal and Vietnam, smoking response to health crises in Burkina Faso). The recent profusion of health • Chronic noncommunicable epidemics (SARS, H1N1, MERS-CoV diseases: an ongoing project and above all Ebola) and the obvious to strengthen capacities in In Burundi, Togo, Niger, Burkina difficulty for resource-limited the field of oncology in Kenya Faso and Chad, among others, the countries and the international in partnership with the Aga hospital partnerships developed community to react appropriately Khan foundation and the Curie have demonstrated the need and as part of the ESTHER Initiative Institute. Other projects are in relative urgency to redefine and have been helping to improve the preparation in diabetes and the reinforce international health quality of services to people living fight against cancer. security (IHS). with HIV for more than a decade.
Expertise France is a versatile key operator in ISH and has solid references in the field since the recent Ebola epidemic during which the agency was assigned a € 22 million project portfolio in Guinea, Liberia and the neighbouring countries by the French task force and European Commission.
The fight against pandemics (HIV/AIDS, tuberculosis, malaria) - the original core activity of Expertise France’s Health Department - is geographically focused on resource-limited African countries The 5% Initiative, managed by the French Ministry of Foreign Affairs and International Development and implemented by Expertise France, was launched at the end of 2011 to give more direct assistance to French-speaking countries receiving Global Fund grants in accessing and implementing programmes to fight AIDS, tuberculosis and malaria.
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FRENCH HEALTHCARE
French Healthcare is an innovative A public-private initiative Concrete objectives in initiative aimed at bringing together bringing together all favor of the promotion of companies, researchers, and healthcare stakeholders French healthcare sectors healthcare professionals to jointly promote their activities internationally. Developed as part of the government French Healthcare will allow strategy to support priority export healthcare stakeholders, grouped in The brand French Healthcare has an “families,” French Healthcare is an an ad hoc structure: ambition: To build momentum through initiative of the Healthcare Industry • To benefit from dedicated a collective approach so as to boost and Technology Strategic Committee communication campaigns the influence of French health know- (CSFITS) designed to improve the (publications and promotional how and technologies. visibility of French health services for events), developed collectively to export. promote their know-how, products, and services. Showcasing French assets The French Healthcare initiative • To welcome foreign delegations is supported by public and private wishing to discover the French France has considerable assets: stakeholders and is based on close healthcare model, plus French • Its public health and training model collaboration between: expertise and technological solutions. enjoys international recognition. • The Ministries of Foreign Affairs • To participate in joint projects for • It is a leading player in global and International Development, export designed to strengthen health healthcare. Economy and Finance, Social Affairs systems, improve access to care, and • French research and the French and Health, and National Education, fight infectious and chronic diseases. pharmaceutical industry are among Higher Education, and Research. the most successful in the world. • Operators (Business France, • It has a proven capacity for Expertise France). http://frenchhealthcare.fr/ innovation in the medical device, • Professional bodies and trade [email protected] animal health, e-health, and silver associations. economy sectors, which are served • Companies, hospitals, research by a dynamic ecosystem of start-ups institutes, innovation centers, and and SMEs. universities.
French Healthcare will promote all these assets worldwide.
Under the high patronage of: Our founding members are:
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CONCLUSION
MARC DE GARIDEL Vice President of the French Healthcare Industries and Technologies Strategic Committee
The many facets of healthcare and patient management whose quality organisations, companies of every size selected for this brochure illustrate is internationally-recognised, know- working in every field, public and private France’s wealth of assets in a sector how in management of healthcare hospitals, doctors, nurses and carers in of fundamental importance to the establishments, the evaluation of private practice, public, private non-profit lives of people throughout the world products and technologies and the and private insurance organisations and and the countries in which they live. implementation of health-insurance patients associations, all of which enable No economic or social development is systems. French healthcare to adapt to a wide possible without universal access to France combines universal access to variety of expectations and requirements, satisfactory health. French healthcare healthcare with excellence in medicine in countries with backgrounds and is particularly comprehensive, starting based on decades of experience while organisations that are often very different. with the research that is essential to remaining at the cutting edge of France has a longstanding tradition of high-level expertise and the ability to scientific knowledge. Another asset is openness, which today is reflected in the respond rapidly to emerging diseases and the complementarity of its stakeholders: desire to share expertise and know-how including the organisation of healthcare administrations, public research that are in keeping with its values.
Under the umbrella of the French Healthcare The French Healthcare Industries and Technologies Public health is one of the major societal challenges Industries and Technologies Strategic Committee Strategic Committee is presided by the Minister in facing countries today. With population ageing, the Each strategic committee (CSF) which corresponds charge of Industry and the other ministers concerned development of multifactorial and chronic diseases, to a strategic sector of French industry, is tasked namely those in charge of Health, Research and the resurgence of infectious diseases and the growing with jointly defining, by means of ‘industry contracts’, Foreign Trade. Steered by a Vice-President from economies of the emerging countries, demand for the key challenges of the sector concerned and the sector concerned, Marc de Garidel (Ipsen), the healthcare solutions is evolving very rapidly. With the reciprocal commitments between industry committee is comprised of industry stakeholder this alliance of public-authority and private-sector stakeholders and the State, as well as defining representatives, companies and industrial stakeholders within the French Healthcare Industries proposals for concrete action and tracking their federations, the five union organisations, the various and Technologies Strategic Committee, France is well- implementation. administrations concerned and experts. equipped to face the challenge.
We wish to thank the authors as well as the international and former Director of CNAMTS Unicancer representatives of the federations, associations French Ministry of Foreign Affairs and International List of the principal websites of the federations and administrations for their contributions to this Development and administrations: document: French Ministry of Social Affairs and Health French Ministry of The Economy and Finance, www.ariis.fr Professor Pierre Corvol, Emeritus Professor at Secretary of State for Industry www.aviesan.fr Collège de France, Honorary administrator of French Ministry of National Education, Higher www.businessfrance.fr Collège de France Education and Research www.diplomatie.gouv.fr www.economie.gouv.fr Claude Bertrand, President of ARIIS (Alliance for ARIIS www.enseignementsup-recherche.gouv.fr Research and Innovation in Health Industries) AVIESAN www.entreprise.gouv.fr/conseil-national-industrie Eric Billiaert, Corporate Communications Manager for Business France www.expertisefrance.fr the Public Sector, Gemalto eHealth France www.fefis.fr Laurent Degos Expertise France www.fehap.fr Jean-Yves Fagon, Ministerial delegate for healthcare FEFIS www.fhf.fr innovation FEHAP www.fhp.fr Marc de Garidel, Vice President of the Healthcare FHP www.fnehad.fr Industries and Technologies Strategic Committee FHF www.france-silvereco.fr Eliane Gluckman, Emeritus Professor FNEHAD www.G5.asso.fr Jean-Patrick Lajonchère, Federator of the priority France silver eco www.leem.org export family Mieux se soigner (‘Better Health’) for G5 Santé www.sidiv.fr the French Secretary of State for Foreign Trade LEEM www.snitem.fr Yves Lévy, President of AVIESAN (National Alliance MEDICEN www.sociale.sante.gouv.fr for Life Sciences and Health) Med Tech www.unicancer.fr Louis Omnes SIDIV www.competitivite.gouv.fr Frédéric Van Roeckeghem, President of MSH SNITEM
Healthcare made in France: excellence at the service of patients – Brochure produced with the support of Atout France, the France Tourism Development Agency – Under the umbrella of the French Healthcare Industries and Technologies Strategic Committee – 2018. Photo credits: Cover ©Sanofi Pasteur/ Christian Fleury ; ICO/Sergio Grazia ; Istockphotos – p.4, 13, 16, 17, 20, 21, 23, 25, 26, 29 ©Istockphotos/DR, Sergey Nivens, V&P Photo Studio, Katazyna Bialasiewicz, SKapl, Sebastian Kaulitzki, Click&Photo, Abel Mitja Varela, Metinkiyak, Sturti ; p.6 ©Sanofi Pasteur/ Christian Fleury ; p.7 ©Master Video ; p.10 ©Laboratoires Servier/E. Legouhy ; p.11 ©Einden Studio ; p.11 ©Patrick Allard/REA ; p.12 ©Sanofi Pasteur ; p.14© ICO/Sergio Grazia ; p.21 ©Vincent Moncorgé ; p.3-18-22-24 ©DR ; p.23 ©Photoshelter ; p.30 ©Thomas Laisné Under the umbrella of the French Healthcare Industries and Technologies Strategic Committee, chaired by the Ministers of Foreign trade, Research, Industry and Health