France's healthcare system is a hybrid model that combines public and private sectors to deliver comprehensive medical services to its residents. This overview addresses the main components of France's healthcare framework, focusing on the organisation of the healthcare system, funding mechanisms, service provision, medicines approvals, and pharmaceutical access.
The newly adopted 2026 budget framework implements significant price cuts for innovative and generic medicines as part of a broader healthcare sustainability strategy.
Inpatient add-on payments (Zusatzentgelte, ZE) are a core mechanism used to reimburse defined high-cost items or services in addition to the DRG case payment, within nationally specified rules and an annually updated national catalogue.
Germany's healthcare system operates under a decentralised, statutory health insurance model offering universal access. Funding is primarily income-based, supplemented by private insurance and out-of-pocket payments. Healthcare services are provided by public, private, and non-profit institutions, with medicines regulated at national and European levels. Reimbursement policies balance comparative-effectiveness assessments with patient access.
Additional national funding for medicines in Italy is used mainly to support timely and consistent uptake of medicines that have been designated as ‘innovative’ for a specific indication, rather than to create a separate route that bypasses routine national pricing and reimbursement.
Italy provides universal healthcare through a tax-funded national health service. Central government sets the national benefits package and the main rules for eligibility, entitlements, and patient charges, while regions and autonomous provinces plan and deliver services and manage budgets.
Italy’s main nationally defined mechanism to support access to innovative medicines is the innovativeness framework administered by the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA).
