Question 16972 — maternity health insurance

Summary

Mr. Stéphane Peu alerts the Minister of Solidarity and Health to the serious consequences of the lack of financial support for screening tests for intolerance by patients to the anti-cancer treatment 5-FU. 5-FU is a particularly potent and common anticancer treatment, but it can cause serious toxic effects in some patients who have dihydropyrimidine dehydrogenase (DPD) deficiency. According to a study by the Marseille regional pharmacovigilance center, pathologies linked to this toxicity were observed in 1,505 people between 2005 and 2015 in France, and led to the death of 133 of them. Unfortunately, such tragedies continue and rightly lead patient defense associations to initiate legal proceedings. This situation is all the more incomprehensible as this deficit in DPD can be screened upstream, as recommended by the National Medicines Safety Agency (ASNM), and in accordance with the recommendations of the Oncological Clinical Pharmacology Group (GPCO). Effective preliminary tests, the marketing cost of which is between 150 and 190 euros, are available. But in the absence of their coverage by the primary health insurance fund (CPAM), their prescription and implementation work is today only a therapeutic option which relies on the strict goodwill of health centers. The inclusion of these tests on the RIHN list (repository of innovative acts excluding nomenclature) does not constitute a sufficient guarantee. This is why it is in the interest of both patients and healthcare structures that 5-FU tolerance tests are covered, as is the case for example in the prenatal screening for Down syndrome. Consequently, he asks her to have the tests concerned included on the list of treatments reimbursable by the CPAM.

Machine translation from French. The official text remains authoritative.

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