Governing (through) Prices: The State and Pharmaceutical Pricing in France.

Summary This article examines the pricing of reimbursed prescription drugs in France from shortly after World War II to the mid-2010s. We analyze the consecutive forms this policy has taken, from unilateral pricing by the state (1948-1980s) to price negotiations between an inter-ministerial committee and pharmaceutical companies, which went into effect in the mid-1990s. On this basis, we show that state price control in France implies two ways of governing markets: government of values, where the idea is to assess medications on criteria of social justice ("la justice sociale")-that is, public health, keeping the national health insurance budget balanced, promoting research and development and supporting industrial employment-and government of behaviors, where the idea is to assess medications in accordance with market accuracy ("la justesse marchande")-that is, ensuring that prices will incline pharmaceutical companies and market actors to behave in ways that will serve state pharmaceutical policy. The aim of determining a just and accurate price through negotiation has regularly given rise to confrontation both within France's inter-ministerial negotiating committee, called the Economic Committee on Pharmaceuticals (Comité Économique des Produits de Santé or CEPS), and between that committee and pharmaceutical companies-in sum, between actors concerned to promote the distinct and antagonistic notions of social justice and market accuracy.