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#519997 - 01/19/20 06:14 PM Access to Biologic medication in France and Spain
mooman Offline

Registered: 03/13/09
Posts: 216

Tried the search for 1 min and failed smile
Currently on Secukinumab (Cosentyx). Might be an offer to move to Nice or Mallorca. Tried global AS charity websites, harder than i thought. Could be Language difference.

France I thought of MollyC - your my only hope smile
Spain I have heard its only through the hospital but how and when and how many pens and is it delivered.

The devil and my fears lay in the details.

Thanks in advance for your help

#520002 - 01/19/20 07:15 PM Re: Access to Biologic medication in France and Spain [Re: mooman]
MollyC1i Offline

Registered: 01/21/04
Posts: 9843
Loc: Brittany, France (since Nov 08...
Hi Mooman - Just caught your post.
I understand that you may move to Nice or to Mallorca, yes ? The AS scene in France is fairly good. Is the 'home' of EULAR, European Legue Against Rheumatism, and also that of ASAS, ASessment in Ankylosing Spondylitis (ASAS) international. Much by way of international education, recognition, imaging, treatment. Of course, the biologics are foremost treatment.
Will need to get your Carte Vitale and top-up Mutuelle. Then follows the ALD - affliction longue dure, which requires a letter from the rheumatologist to establish ALD and, bingo, any problems to do with AS are covered, including basic hospital stays. Outside of AS, not necessarily covered, except by what is pick up by your Mutuelle. (insurance). Mutuelle comes in quite a range of charges, depends on how far / much you might seek coverage. I have a pretty good one, though is a tad costly.
Nice itself, there is a good hospital there, has an excellent orthopaedic dept with a top rated international shoulder surgeon, speaks English. Don't know what their rheumy dept is like, but check out CHU Nice website for information.
Will need a GP to do the referrals, that will take about 6 months to go through the bureaucracy, meantime, they give you a temporary paper, 'they' being CPAM -
ameli, le site de l'Assurance Maladie en ligne | | Assuré
Translate this page
Le site officiel de l'Assurance Maladie. Actualités – Droits et Démarches – Remboursements – Prestations et aides – Santé – Offres de prévention.
The French 'love' their medications and expect to leave a consultation with an arms length of prescribed items !
The system is pretty good, you can see whomsoever 'you' would like to see - means one can travel to see the best. Can get expensive though !
Ophthalmology is one of the worst areas that is not well covered by expertise, and ophthos are thin on the ground, can be a year to get an appointent, and, not all are equal ! Hmmmm.
Although the English is the lingua franca of medicine, not all docs speak English though the top specialists will be speaking - they have to, not all paper are translated, and symposiums and conferences etc (visiting top level consultants) are held in the English language. So far I have managed to get by, though my French is really a tad scrappy !
Imaging is generally done in an imaging centre - find the best one. Hospitals and clinics have their own centres, but also there are many stand alone imaging centres, on the whole, pretty good. The same with haematology, one goes to the blood clinic. Generally walk in, will need a prescription, no need to make an appointment, and await your turn.
Hospital food tends to be from ghastly to almost inedible ! Nursing, can be excellent to a bit hit and miss. Doctors tend to think themselves God's gift...nowt much changes there. Hospital rooms, clean, not too much by way of contamination. One does see rather a lot of internes = students. A mixed bunch of course, from truly excellent to downright Ho-Hum !
Always keep your records and paperwork in order and, of course, your own MRIs, CTs, ultrasounds etc etc. One is given reports and copies of diagnostics. Keep them safe. Medics here tend not to liaise with other medics who may be attending your case - that is pretty much left to ones GP...who may or may not follow through ! You have to be prepared to get involved in your own care and at the same time careful not to tread on 'tender' toes...!! Make out your own medical notes and list of drugs and list of ALL drugs that have caused unwanted reactions. (When I give them ine, they are question away, until satisfied. Can be a bit of a bore that. Meds you currently take. Meds you refuse to take for whatever reason, list of meds that cause horrid reactions. Keep these up-to-date, and make copies).
Think that is about it. Any questions, fire away.

CHU=Central University Hospital - many internes / 3rd year students in attendance. The pvt cliniques are generally run on a tighter rein.
OK. I'll leave that lot with you. Night -
Molly C (France)
P.S. That was Mallorca you said. Only thing I know of Spain is that it is nowhere near the standards of France. Between the two, I would seek to go to Nice.

Edited by MollyC1i (01/19/20 07:19 PM)
Edit Reason: for the P.S.- Mallorca
MollyC1i - Riding OutAS

#520005 - 01/20/20 01:24 PM Re: Access to Biologic medication in France and Spain [Re: mooman]
MollyC1i Offline

Registered: 01/21/04
Posts: 9843
Loc: Brittany, France (since Nov 08...
Mooman - As far as I know there is no problem to accessing the biologics. Will require a prescription from your French accredited rheumatologist. To obtain such, GP refers to rheumy, then up to rheumy to write out the prescription. So longas *also have the ALD designation, nothing to pay - CPAM / your mutuelle picks up the tab, automatically.
There is a French spondy Association - rather in to pushing the jolly old biologics, see AFS -
Ohhh - perhaps not 'see AFS' - was a member for a number of years, looks rather like the Society has diluted.... found this : Not much cop. Oh well. So long as EULAR and AAS continue - butSociety sad that the once vibrant AFS has looked to nose dived. Needs dedication to thrive, nowt here like NASS or ASAS more's the pity.
OK. Any other that pass my mental registration, will pipe up...
Molly C (France)
Keeping on - Keeping on - as we all do, innit <VBG>
MollyC1i - Riding OutAS

#520014 - 01/24/20 03:18 PM Re: Access to Biologic medication in France and Spain [Re: MollyC1i]
mooman Offline

Registered: 03/13/09
Posts: 216
Awesome info, thanks Molly C. I knew I could count on you. Yes the language gap will be the most daunting but not impossible.

#520016 - 01/24/20 04:40 PM Re: Access to Biologic medication in France and Spain [Re: mooman]
MollyC1i Offline

Registered: 01/21/04
Posts: 9843
Loc: Brittany, France (since Nov 08...
Just reread my second note - help ! Bit muddled, ASAS, then SAA. and in between, a melange of the two ! But am sure you will untangle it all... My laptop jumps text, and on top of that I only have vision in one eye, so I miss items. Heigh-Ho.
Glad to have helped out some -
By the way, presume you will be in employment when you come over, in which case your employers should be doing all the slog work, and the mutuelle should be part and parcel of yr employment contract.
A reasonable English language French based newspaper is the Connexion - a stack of reasonable tips to living and coping in France, including info on the health system, employment, tax / fiscale, renting property, etc etc.
Take care - go well -
Molly C
MollyC1i - Riding OutAS

#520018 - 01/27/20 11:27 AM Re: Access to Biologic medication in France and Spain [Re: MollyC1i]
Dotyisle Offline

Registered: 03/07/02
Posts: 9521
Loc: Rosario, Argentina
Hello Molly,

Hope all is well.. had an Argentine Labor Law training last week, stated the Argentine laws came from France.


AS may win some battles, but I will win the war.

KONK - Keep ON Kicking

#520020 - 01/27/20 01:56 PM Re: Access to Biologic medication in France and Spain [Re: Dotyisle]
MollyC1i Offline

Registered: 01/21/04
Posts: 9843
Loc: Brittany, France (since Nov 08...
Hi there Tim - How interesting. Well, the french are prone to 'le greve' i.e. protests against rules and regulations various - at the moment, it is protests against retirement and pension rights. Ports closed; trains; not running; hospital emergency closed; schools, on strike; doctor's surgeries...quasi closed ! Happening two to three days per week !
As for the laws of inheritance...Ho-Hum. Still Napoleonic. So many houses unable to be sold, as the inheritors refuse to agree to the sale, so said house, chateau, falls into ruin. One right next door to me, like so many all over France. Could go on, from 'sale time. Ah-Ha. All shops have to have their sales 'at the time of the year' this so as no shop shall take advantage over another ! (There are exceptions...!) So it goes. Can laugh and, grind teeth !
Nice touching base Tim. hope all well with Matteus (Sp?).
Molly C
Still Keeping on, Keeping on
Have fun with the laws where you live <smile>
MollyC1i - Riding OutAS


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