title: REIMBURSEMENT OF CELL-BASED REGENERATIVE THERAPY IN THE UK AND FRANCE.
abstract: Cell-based regenerative therapies are presented as being able to cure the diseases of the twenty-first century, especially those coming from the degeneration of the aging human body. But their specific nature based on biological materials raises particular challenging issues on how regulation should frame biomedical innovation for society's benefit regarding public health. The European Union (EU) supports the development of cell-based regenerative therapies that are medicinal products with a specific regulation providing their wide access to the European market for European patients. However, once these medicinal products have obtained a European marketing authorisation, they are still far away from being fully accessible to European patients in all EU Member States. Whereas there is much written on the EU regulatory system for new biotechnologies, there is no systematic legal study comparing the insurance provisions in two EU countries. Focussing on the situation in the UK and France that are based on two different healthcare systems, this paper is based on a comparative methodological approach. It raises the question of regulatory reimbursement mechanisms that determine access to innovative treatments and their consequences for social protection systems in the general context of public health. After having compared the French and English regulations of cell-based regenerative therapy regarding pricing and reimbursement, this papers analyses how England and France are addressing two main challenges of cell-based regenerative therapy, to take into account their long-term benefit through their potential curative nature and their high upfront cost, towards their adoption within the English and French healthcare systems. It concludes that England and France have different general legal frameworks that are not specific to the reimbursement of cell-based regenerative therapy, although their two current and respective trends would bring more convergence between the two systems while addressing the main challenges for the reimbursement of these therapies. Nevertheless, despite their current differences, neither the English nor the French national healthcare system has yet approved the reimbursement of cell-based regenerative therapies. The paper highlights where both systems could be learning from each others' experiences to favour the adoption of cell-based regenerative therapies through the adaptation of their reimbursement methodologies. It also emphasises the gap between market access and patients' access, and it calls for research and discussions through reflexive agencies such as the Regenerative Medicine Expert Group in the UK.
authors.affiliation: Centre for Global Health Policy, School of Global Studies, University of Sussex, Falmer, Brighton BN1 9RH, UK aurelie.mahalatchimy@gmail.com.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Mahalatchimy
mesh_terms: D004739:England; D005062:European Union; D005602:France; D006801:Humans; D044968:Regenerative Medicine / Q000191:economics*; D012051:Reimbursement Mechanisms; D033581:Stem Cell Transplantation / Q000191:economics*; D006113:United Kingdom
keywords: Access; England; France; Pricing; Regenerative therapy; reimbursement