5.13. Complementary and alternative medicine

There is no general regulation and very few data regarding complementary and alternative medicines in France. Some of the drugs and practices that may fall under this category, such as homeopathy, acupuncture and, to a lesser extent, osteopathy, play a significant role in the French health care system. Recent debates have emphasized the need to monitor the development of diverse and mostly uncontrolled health-related practices in order to limit fraudulent activities.

France is the largest national market for homeopathic products. These products are regulated by the public health code, which provides a definition for homeopathic drugs and distinguishes between two types of homeopathic substance, which fall under different regulatory frameworks. First, products that are extremely diluted (so that they are considered innocuous), which are administered orally or by external application and which are commercialized without any pre-specified therapeutic purpose, need only to be declared to the ANSM before commercialization. They may be covered by SHI at 30% and, in that case, their price is regulated. These represent the vast majority of homeopathic products. Second, all other homeopathic products (notably those that are being sold with a specific therapeutic indication) must follow the AMM process for new drugs before entering the market and are not covered by SHI. Distribution of homeopathic products is subject to the same restrictions as conventional drugs.

Acupuncture has been recognized as a medical activity in the common classification of medical activities for more than 20 years and is covered by SHI with a tariff that is currently half the tariff for a standard GP visit. Finally, osteopathy sessions, while not recognized as a medical activity, are covered by a number of VHI contracts, often on an annual lump sum basis and only when referred by a physician.