Health plan on research and innovation: “Money will not solve everything”

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Emmanuel Macron unveiled on Tuesday the main lines of his health plan: 7 billion euros to stimulate investment in research and innovation. A laudable initiative but which will not be enough to revive French industry abroad, according to economist Frédéric Bizard.

Make France a European leader by 2030. Tuesday, June 29, Emmanuel Macron unveiled his plan to revive French research and innovation in the field of health. An investment of around 7 billion euros to develop biotherapies (innovative therapies including messenger RNA), digital health as well as research programs and sites.

Combining public and private funds, this plan should in particular make it possible to catch up with France, highlighted by the Covid-19 pandemic and the failures of French research on vaccines. “I, like many of you, have noted the cumbersome things that have slowed down our system. (…) Our large structures were not the fastest in the world ”, recognized the Head of State in a speech at the Élysée. To analyze the ins and outs of the health plan, France 24 spoke with Frédéric Bizard, associate professor of economics at ESCP Business School and president of the Institut Santé.

Does Emmanuel Macron’s choice to focus on innovative therapies by developing research programs and sites seem right to you?

Frédéric Bizard: Setting up a plan dedicated to medical therapeutic innovation in order to make France a major player in research and innovation is of course a good direction. But the question is whether we really give ourselves the means. The plan is based on the premise that the system is strong and that it is enough to give back funding to re-create momentum. However, the ecosystem of research, industry and protection is in an advanced state of decomposition and it must be completely rethought. France missed the turn of biotechnology ten years ago and it is missing that of genomics today. Of course, Emmanuel Macron underlined the red tape and the desire to speed up the processes, but there is currently no concrete reform that goes in the direction of a profound overhaul of the system.

What do you think should be the priority for relaunching the research and innovation industry?

In France, we have a real drug governance problem with several intermingling agencies: HAS (Haute Autorité de Santé), CEPS (Economic Committee for Health Products), ANSM (National Agency for the Safety of Medicines and Health Products) ) … This ultra-bureaucratic system generates competition and considerably slows down the process for obtaining authorizations, which is on average 500 days in France against 100 in Germany. The priority must be to abolish these agencies and put in place effective horizontal governance.

The government is currently working on the creation of an innovation agency. This is a good idea, on condition that it replaces the others, especially since many stages are now managed at European level. A single agency must manage the medical and medico-economic assessment in a transversal manner. The relationship to research must also be reassessed; the French-style egalitarian system which gives all researchers the same means is worn out and generates a brain drain. In this field, it is like in sport, it is necessary to be able to select and take risks because an extraordinary researcher can revolutionize a field.

Does the amount of 7 billion euros announced by the president seem to you up to the stakes?

There is of course a financial stake to restore France to a competitive power in the field of medical research. Public investment has fallen by 28% in ten years, to 2.5 billion euros. Germany has increased its investment over the same period, reaching 6 billion. There is therefore a deep gap to be made up which the government seems to be taking the measure of. But it will be necessary to judge this investment in detail and ensure that it allows for lasting improvement.

To become competitive again on a European scale, French medical research would need a sustainable budget of around 5 billion euros per year. However, health is governed by an annual financing law which prevents any medium-term visibility. We would need a programming law over five years, as we do for the military. This system would encourage investments and risk-taking by industrialists. Because the amount of 7 billion announced includes a part of private financing, but the field of research is not very attractive in France; most clinical studies are carried out in countries with less stringent regulations, such as Belgium or Spain. All is not lost, France has resources, in particular excellent researchers, and the Covid-19 crisis has generated awareness that can help build the pharmaceutical ecosystem of the 21st century to once again become a major international player. . But to get there, money will not solve everything, we have to rethink the system.

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