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Whether you’ve just moved to France or have been living here for years, navigating the pharmacy system can raise a lot of questions, especially around what medications cost and how much you'll actually be reimbursed.
From prescription drugs and over-the-counter remedies to the role of the Carte Vitale and mutuelle insurance, understanding how pharmacy costs and reimbursement work is essential for managing your health and your budget. The good news? France has one of the most affordable systems in Europe, thanks to strict price regulations and generous public coverage, if you know how to use it properly.
In this guide, we’ll break down everything you need to know about pharmacy costs and reimbursement in France, including how to use your insurance, what’s covered, and how to avoid unexpected out-of-pocket expenses.
How Pharmacies Work in France
French pharmacies are an essential part of everyday healthcare. Easily recognised by their green cross signage, pharmacies in France serve as both retailers of medication and primary health advisors for common illnesses.
Pharmacists in France are highly trained medical professionals. They can provide medical advice, check prescriptions, suggest over-the-counter remedies, and explain how to take your medication. Many speak some English, especially in major cities and expat-heavy areas.
Pharmacies in France are not self-service. Medications, both prescription and non-prescription, are kept behind the counter. You’ll need to speak with the pharmacist, even for everyday items like paracetamol or cold medicine.
Opening hours are generally Monday to Saturday, 9am to 7pm. In case of emergency, there are always pharmacies de garde (on-call pharmacies) open on Sundays and overnight, usually rotating within each area.
How Much Do Medications Cost in France?
In general, medicine in France is affordable, especially if you’re covered by the national health system. Prices are regulated by the government, which keeps them significantly lower than in countries like the US.
Here are a few examples of typical pharmacy costs:
➡️ Amoxicillin (antibiotic): 3 €– 5 € with prescription, before reimbursement
➡️ Ibuprofen (200mg, 30 tablets): 2 € – 4 € over-the-counter
➡️ Contraceptive pill (monthly pack): 2 € – 10 € depending on brand
➡️ Paracetamol (Doliprane 1000mg, 8 tablets): 2 €
➡️ Nasal spray or decongestant: 3 € – 7 €
➡️ Emergency contraception: 5 € – 20 € depending on brand and age
Note that prices can vary slightly between pharmacies but remain within a tight regulated range. Some medications may be free or nearly free if you're eligible for full reimbursement.
What Is Reimbursed by French Health Insurance?
If you're part of the public health insurance system (PUMA), many medications are partially reimbursed through Assurance Maladie, depending on their medical necessity.
Every reimbursable medication comes with a reimbursement code and coloured vignette (label) on the packaging. These indicate whether the drug is eligible for reimbursement and at what percentage. There are four main reimbursement levels: 15%, 30%, 65%, and 100%.
To benefit from reimbursement, you must present a valid prescription and your Carte Vitale at the pharmacy.
👉 Go further with our article What’s Covered by Basic Public Healthcare in France?
Understanding Reimbursement Rates: 15%, 30%, 65%, 100%
French health insurance doesn’t cover all drugs equally. Instead, it categorises them by their medical usefulness.
100% Reimbursed
These are vital medications, often for chronic illnesses or serious medical conditions. Examples include insulin, chemotherapy treatments, and some antibiotics. Patients with an ALD (Affection Longue Durée) condition also benefit from full reimbursement.
65% Reimbursed
This is the most common category. It covers essential treatments such as most antibiotics, blood pressure medications, and antidepressants.
30% Reimbursed
Covers drugs deemed useful but not essential, for example, treatments for minor conditions.
15% Reimbursed
These are considered to have low medical value. Many of these products are no longer reimbursed at all and must be paid entirely out of pocket.
The rest of the cost, the portion not covered by public insurance, is often covered by your mutuelle, depending on your policy.
Do I Need a Prescription to Get Reimbursed?
Yes. To qualify for reimbursement through the public health system, the medication must be:
1️⃣ Prescribed by a doctor registered in France, and
2️⃣ Listed on the official list of reimbursable medications
Over-the-counter (OTC) medications, such as basic cold remedies, are not reimbursed unless they are specifically prescribed. This surprises many newcomers, as drugs commonly purchased without prescriptions elsewhere often require one in France to benefit from reimbursement.
If your doctor prescribes a medicine that is not on the reimbursable list, you’ll have to pay the full amount, even if you present your Carte Vitale.
Using Your Carte Vitale at the Pharmacy
The Carte Vitale is your golden ticket to reimbursement. It’s a green smart card issued by CPAM, containing your social security and insurance information.
When you fill a prescription at the pharmacy, hand over your Carte Vitale and prescription. The pharmacist will enter your details, and any covered medications will be automatically reimbursed. The pharmacy receives payment from Assurance Maladie, and you only pay the remainder, if anything.
If you forget your card, you'll pay the full amount upfront and will need to submit a paper reimbursement claim (feuille de soins) to get your money back.
What About Mutuelle Coverage for Medications?
Because public health insurance only reimburses a portion of medication costs, most residents take out a mutuelle (supplemental health insurance). A good mutuelle will cover:
✅ The remaining 30–85% of prescription costs
✅ 100% of OTC medications (only in premium plans)
✅ Higher-level coverage for chronic conditions or specialised treatment
✅ Additional services like homeopathic remedies or alternative medicine
Your pharmacist will see your mutuelle details when scanning your Carte Vitale, so if your mutuelle is correctly linked, you typically won’t need to advance any money at all.
Not all mutuelles are the same. Some offer only basic drug reimbursements, while others cover a much broader range of products, including medications not reimbursed by the public system.
👉 Want to compare mutuelle options? Get a free quote
Buying Medicine Without Insurance in France
If you’re a tourist, digital nomad, or recently arrived expat not yet registered with CPAM, you’ll need to pay pharmacy costs in full. Prices are still relatively affordable compared to many other countries, but there are a few tips to keep in mind:
➡️ OTC availability is limited. Many medicines commonly sold over the counter elsewhere require prescriptions in France (e.g., strong cold meds, antibiotics).
➡️ Always ask the pharmacist if there is a generic version (générique) available. These are often much cheaper and just as effective.
➡️ Keep all receipts and ask for a detailed invoice (facture) if you plan to submit the costs to a private or international insurer.
In cases of long stays or residency applications, you’ll eventually need a policy that meets French visa insurance requirements. These often include coverage for medication, hospitalisation, and emergency care.
To wrap it all up
Understanding pharmacy costs and reimbursement in France is key to navigating everyday healthcare as a resident or expat. While the French system offers some of the most affordable and efficient pharmacy services in Europe, it’s important to:
✅ Use your Carte Vitale for automatic reimbursements
✅ Obtain prescriptions for reimbursable medication
✅ Consider a mutuelle to limit your out-of-pocket costs
✅ Be aware of how reimbursement tiers affect what you pay
By combining public coverage with a well-matched supplemental insurance plan, you can reduce your pharmacy expenses and enjoy one of the best healthcare systems in the world, without the surprises.
