Minister Makes French Hypochondriacs Cough Up for 'imaginary' Medication

Europe's champion pill-poppers will be denied several hundred of their favourite prescription drugs from today when the French government publishes a list of medicines whose users will no longer be reimbursed by the health service because they have little or no recognised effect.

After six months of talks with healthcare professionals and a bruising battle with the pharmaceutical industry, the health minister, Jean-François Mattei, will publish a list naming up to 650 medicines routinely prescribed by French doctors but shown to give "an insufficient medical return".

They are likely to include such dubious but widely used Gallic remedies as "veino tonics" (for the circulation), "bronchial lubricants", "hepatitic protectors" (for the long-suffering French liver), "phytotherapeutics" (plant-based medicines), "choleretics" (for the secretion of bile), and a whole class of products known as "replacement intestinal flora".

The French, a nation of unrepentant hypochondriacs, take three times as many prescription drugs as the Germans and the British, and twice as many as the Italians.

A recent survey estimated that doctors were prescribing mood-altering medicines to 12% of the adult population.

Taking their cue from the hero of Le Malade Imaginaire, (The Imaginary Invalid), by the 17th-century playwright Molière, the French suffer from afflictions that no one else recognises.

La crise de foie (liver crisis), for which every French pharmacist stocks a panoply of remedies, is diagnosed elsewhere as headache, constipation or plain over-indulgence at the table.

Some daring health professionals are now starting to wonder openly whether the French attitude towards illness produced their widely admired national health system, ranked best in the world by the World Health Organisation, or the system turned them into a nation of imaginary invalids.

Edouard Zarifian, a professor of medical psychology, diagnoses two causes: inadequately trained GPs who refuse to send their patients away without the sheaf of prescriptions they demand, and the unchecked influence of the big drugs companies.

Whatever the underlying reason, Mr Mattei was prompted to take action on financial rather than medical grounds.

Faced with an over-run of €6.1bn (£4bn) on the health service budget last year, the minister hopes that by forcing patients to reach into their own pockets for between 20% and 25% of the 4,300 different medicines taken in France he will be helped to beat the deficit.