From Complications to Prevention: France’s new approach to reimbursed care
On 28 May 2026, the French government announced a landmark policy decision that will have far-reaching implications for obesity care across Europe. From 15 June 2026, eligible people living with obesity who meet eligibility criteria and prescribing requirements will be able to access reimbursed obesity management medications through the French healthcare system, with reimbursement levels of up to 65% and, in some circumstances, higher levels of coverage through existing long-term disease mechanisms.
This decision reflects the growing recognition that obesity is a chronic, relapsing disease requiring evidence-based, long-term management, and that access to effective care should not depend solely on ability to pay. The French decision aligns closely with principles embedded within the EASO Framework for the diagnosis, staging and management of obesity.
The EASO Framework recognises that BMI alone is insufficient to assess disease burden and clinical need and supports a more comprehensive assessment of obesity-related medical, functional and psychological complications, enabling healthcare professionals to deliver person-centred, evidence-based care tailored to individual needs and risks.
Importantly, the Framework recognises obesity as a chronic disease and supports intervention based on health risk and clinical need rather than waiting until severe complications have developed. This includes consideration of the full spectrum of evidence-based obesity management options, delivered through person-centred clinical care and supported by multidisciplinary teams where appropriate.
EASO has consistently advocated for healthcare systems to move beyond a reactive model that focuses predominantly on managing downstream complications of obesity, including type 2 diabetes, cardiovascular disease, chronic kidney disease, liver disease and certain cancers. Instead, obesity itself should be recognised and addressed as an important disease requiring timely, evidence-based intervention.
The French reimbursement decision represents an important example of this shift in practice. By supporting access to evidence-based obesity management for people at greatest risk, policymakers are acknowledging that preventing complications is often more effective, more humane and potentially more cost-effective than managing those complications once they have become established.
The Long Road to Recognition
Scientists, clinicians, advocates and policy makers have been working on this for years.
In December 2024, the Haute Autorité de Santé (HAS), France’s independent health technology assessment body, issued a favourable opinion supporting reimbursement of semaglutide for adults living with severe obesity who met specific clinical criteria. This followed an extensive review of the available evidence on effectiveness, safety, health outcomes and economic considerations.
Throughout 2025, negotiations continued regarding pricing, reimbursement mechanisms and implementation. The process reflected the complexity of integrating new therapies into publicly funded healthcare systems while ensuring responsible stewardship of healthcare resources.
The final announcement in May 2026 marked the culmination of this process and established France as one of the first countries in Europe to introduce broad national reimbursement for obesity management medications within a publicly funded healthcare system. We applaud our colleagues in AFERO, EASO’s French National Association member and the patient communities in France for advocating and supporting this initiative.
Aligning Access with Clinical Need
One of the most significant aspects of the French approach is the eligibility framework.
The criteria broadly mirror those traditionally used in France for metabolic and bariatric procedures:
BMI ≥40 kg/m², regardless of complications; or
BMI ≥35 kg/m² with obesity-related complications or comorbidities.
This alignment is important because it places pharmacological management within an established continuum of obesity care rather than treating it as a separate or exceptional intervention.
The new policy acknowledges that obesity management requires a range of evidence-based options, including behavioural interventions, nutritional support, physical activity, psychological care, obesity management medications and metabolic/bariatric procedures where appropriate.
Reducing Barriers to Care
For many people living with obesity, the cost of medication remains a major barrier to care.
Even when effective therapies are available, out-of-pocket costs can place them beyond the reach of many patients, creating inequities in access. The result is that individuals who may benefit clinically are often unable to receive appropriate care, while obesity-related complications continue to develop or worsen.
The French decision addresses this challenge directly by recognising that the costs associated with untreated or undertreated obesity frequently exceed the costs of appropriate early intervention.
Obesity is associated with increased risk of:
- Type 2 diabetes
- Cardiovascular disease
- Chronic kidney disease
- Metabolic dysfunction-associated steatotic liver disease (MASLD)
- Several cancers
- Musculoskeletal disorders
- Sleep apnoea
- Mental health complications
These conditions account for substantial healthcare expenditure across Europe and contribute significantly to avoidable morbidity, disability and premature mortality.
Investing Earlier to Reduce Long-Term Costs: Inaction defeats prevention
Across Europe, health systems are facing increasing pressure from chronic diseases associated with obesity.
Costs associated with obesity-related complications (ORCs) extend far beyond direct medical expenditure. They include tremendous human cost, increased hospital admissions, long-term medication use, disability, reduced workforce participation, social care requirements and wider economic impacts.
As populations age and rates of obesity continue to rise, many healthcare systems will struggle to remain sustainable if resources continue to be directed primarily towards managing advanced complications rather than preventing them.
The French approach reflects an emerging understanding that investment in earlier, evidence-based obesity management may help reduce future expenditure associated with cardiovascular disease, type 2 diabetes, chronic kidney disease, liver disease and other obesity-related conditions.
This is particularly relevant given growing evidence that obesity acts as a gateway disease, increasing the risk of multiple non-communicable diseases that account for a substantial proportion of healthcare spending across Europe.
A Potential Model for Europe
The importance of the French decision extends beyond France itself.
Across Europe, reimbursement policies for obesity management medications remain highly variable. In many countries, access is limited, inconsistent or dependent on private payment.
At the same time, healthcare systems across Europe are facing rising prevalence of obesity and increasing rates of obesity-related complications. Policymakers are increasingly recognising that delaying intervention until complications emerge is neither clinically optimal nor economically sustainable.
France has demonstrated that it is possible to establish a structured, evidence-based reimbursement pathway that:
- Recognises obesity as a chronic disease.
- Prioritises people with the greatest clinical need.
- Aligns pharmacological management with established obesity care pathways.
- Maintains appropriate clinical oversight.
- Supports equitable access to care.
- Seeks to reduce future healthcare costs through earlier intervention.
Each European country will need to develop policies suited to its own healthcare system. The French model provides a practical example of how reimbursement can be conceptualised and implemented responsibly and systematically.
Perspectives d'avenir
The impact of this policy will be closely watched by governments, health technology assessment bodies, payers, healthcare professionals and patient organisations throughout Europe.
As countries seek solutions to rising rates of obesity and obesity-related disease, the French experience may provide valuable evidence regarding implementation, health outcomes, patient access and healthcare resource utilisation. If successful, this initiative could represent not only a milestone for France, but also an important turning point in the European approach to obesity care.
For people living with obesity, the significance is clear: recognition that obesity deserves the same evidence-based, person-centred approach afforded to other chronic diseases, and that access to effective care should be determined by clinical need rather than ability to pay.
France’s decision reflects a growing recognition that obesity should be addressed with the same seriousness, evidence-based approach and long-term perspective applied to other chronic diseases. As European health systems continue to confront rising rates of obesity and obesity-related complications, this policy may provide an important example of how earlier intervention, equitable access to care and investment in the prevention of complications can improve health outcomes while supporting the long-term sustainability of national healthcare systems.
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