Why is France so greedy in granules?

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At Boiron, a French company that manufactures and distributes homeopathic pharmaceutical preparations in Illkirch-Graffenstaden. – G. Varela / 20 Minutes

  • This Wednesday, the High Authority of Health must give its opinion on the merits (or not) of the reimbursement of homeopathy.
  • After months of heated debates between pro-homeopathy and anti, this opinion should be followed by the Minister of Health.
  • France is an exception, both because of the importance of its consumption and because of its attachment to this practice, which is disputed elsewhere.

Since November 2017, the UK health system no longer reimburses homeopathy. In a country where these granules remain scarce and their prescription disputed, the decision of the National Health Service did not provoke an outcry. It's a different story in France,
where the High Authority of Health should, except big surprise, decide this Wednesday (but make its decision public only Friday) to derogate homeopathic products. Two camps are engaged in a row battle for months on these granules, in a nation – France – "champion" in the matter.

A French "passion"

This French exception is first observed in consumption. According to an Ipsos poll from November 2018 to
Boiron, leader of the sector, 77% of the French have already resorted to homeopathy. Only 28% of Belgians have already used it (according to a 2013 study), and 30% of Spaniards (2014). In addition, three quarters of French people surveyed by Ipsos consider homeopathy to be effective. A shared confidence by a part of the medical community. According to
National Syndicate of French Homeopathic Doctors, about 5,000 French doctors practice homeopathy as their main activity. An attraction also illustrated by the success of a petition in favor of keeping the refund at 30%,
launched by Boiron, who recently exceeded one million signatures.

"The French market accounts for 60% of our business, which means that on a turnover of 600 million euros in 2018, we make 360 ​​million euros in France, says Boiron. And of this figure, 60% of homeopathic medicines are reimbursable. This is to say if the lab plays big.

But for the defenders of homeopathy, there is no French passion to question. "The French exception is the excellent health coverage that includes homeopathy, among others, corrects Hélène Renoux, homoeopathic generalist and president of the Society Savante Homeopathy. If we go off the hook, it means we are aligning ourselves with countries that dream of having the same coverage. "

Illustration of the homeopathy department of a pharmacy.
Illustration of the homeopathy department of a pharmacy. – GUILLAUME SOUVANT / AFP

Jobs and diplomas

"One word: lobbying, judge Céline Berthié, general practitioner in Gironde and member of the collective No Fakemed. Boiron is a French group, the world leader and he makes his profit on the credulity of the French. Saying stop repayment means putting jobs in danger. For Vincent Renard, general practitioner and president of the
National college of CNGE teaching generalists, the French exception is linked to two specificities. "Homeopathy benefits from an exception to common law, since the reimbursement of granules does not depend on scientific evidence of their effectiveness, but an important recognition: the Order of Physicians recognizes this specialty, training exists at the university. Second characteristic: the economic weight and influence of homeopathic laboratories ", namely Boiron, Weleda and Lehning. "There is no evidence of this causal relationship, but a strong suspicion," ironically this general practitioner, little adept granules.

Answer "sweetened" on the side of the world leader in granules: "Historically, the designer of homeopathy (the German doctor Samuel Hahnemann) ended his life in France, recalls Boiron. But above all, for ninety years, Boiron has established and developed in France to provide quality products. And thus give its nobility to this therapy. "

And at our neighbors?

What is certain is that the status of homeopathy varies greatly among Western countries. France and Germany are the leading duo. On the other side of the Rhine, doctors, but also non-medical homeopaths, can prescribe these granules, reimbursed up to 100%. "In Switzerland, after a government study and a referendum, homeopathy was included in the reimbursement of care in 2012," adds Hélène Renoux, also president of the European Homeopathy Committee. In contrast, Scandinavian countries, such as Norway and Denmark, have banned the prescription of homeopathy to doctors. More radical, in Quebec, doctors who prescribe homeopathy expose themselves to sanctions of the Order.

In southern Europe, the practice is not widespread. Italy did not do without the societal debate on the usefulness and the danger of these granules in 2017, after the death of a child treated to homeopathy. In Spain, a sling has been organized since 2018. Madrid requires evidence of effectiveness, and some homeopathic trainings have been abolished, in line with the recommendations of the
Scientific Council of the Academies of European Sciences (Easac). In November 2017, he issued a very clear statement on the subject: "The scientific claims of homeopathy are not plausible and are incompatible with the established concepts of chemistry and physics". All by sending each country back to its responsibilities …

The battle of legitimacy

The decision of the HAS, if it confirms the provisional opinion of May to deride, and if it is followed by the Minister of Health, could show that the wind turns for homeopathy, even in France. Knowing that this flip-flop does not really date from this year.

As of 2003, homeopathic products, then reimbursed at 65% by the Social Security, had indeed seen this rate lowered to 35%, then to 30% in 2011. For the first time, the Order of Doctors had come out of his silence , in June 2018, for an "update": "the media use of the terms" alternative and complementary medicine ", particularly concerning homeopathy, is ambiguous which is a source of confusion and disputes of interpretation, "he said. By mid 2018, two faculties had decided to suspend (for Lille) and to cancel (for Angers) the university diploma of homeopathy. Proof that the debate was growing.

Today, defenders of homeopathy fear that the disbursement is a decisive step in the discrediting of this practice. But the No Fakemed collective, the origin of a virulent forum against homeopathy, in March 2018, hopes for its part that this turnaround will not stop in so good way. "The next step for us would be to stop the mixing of genres, argues Céline Berthié, generalist and member of the collective. We do not want to ban it, we do not want to stigmatize the people who take it, but we want the doctors to choose. Either they are doctors, and rely on the acquired data of science, or they decide to be homeopaths. Patients trust us, we are not here to slip our beliefs.

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