Tableau de bord - statistiques.msa.fr · Décembre 2017 Tableau de bord LPP La liste des produits et prestations (LPP) remboursés par le régime agricole en 2016 DIRECTION DELEGUEE

Tableau de bord Liste des Produits et Prestations

remboursables en 2016 Dcembre 2017

Dcembre 2017

Tableau de bord LPP

La liste des produits et prestations (LPP) rembourss par le rgime agricole en 2016

DIRECTION DELEGUEE AUX POLITIQUES SOCIALES DIRECTION DES STATISTIQUES, DES ETUDES ET DES FONDS Directeur de la publication : Nadia JOUBERT [email protected] Rdacteur en chef : David FOUCAUD [email protected] Dpartement Rgulation, Evaluation et Etudes en Sant : Vronique DANGUY [email protected] Annie NOURRY [email protected] Tristan HAGUES [email protected] Diffusion : Claudine GAILLARD [email protected];fr Nadia FERKAL [email protected]

DIRECTION DU CONTROLE MEDICAL ET DE LORGANISATION DES SOINS Collge mdical : Dr Sandrine FARE [email protected]

mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected];frmailto:[email protected]

2

SOMMAIRE

LES DONNEES 2016 ...................................................................................................................................................................................................................................................... 4

1. LA DEPENSE GLOBALE DE LA LISTE DES PRODUITS ET PRESTATIONS ....................................................................................................................................................................... 6 2. VUE ASSURANCE MALADIE ............................................................................................................................................................................................................................. 7 3. VUE ASSURE .................................................................................................................................................................................................................................................. 9

ANNEXES ........................................................................................................................................................................................................................................................................ 9

GRAPHIQUES 1 A 11 - LES REPARTITIONS DES POSTES DE REMBOURSEMENT DE LA LPP EN 2016 ................................................................................................................................... 10 GRAPHIQUE 12 LES 10 CLASSES PRESENTANT LES PLUS FORTS RESTE A CHARGE DE LA LPP EN 2016 ......................................................................................................................... 14 TABLEAU 1 - LES GRANDES CLASSES TECHNICO-THERAPEUTIQUES EN 2016, PAR MONTANT REMBOURSABLE - NIVEAU 1 ................................................................................................... 14 TABLEAU 2 - LES CLASSES TECHNICO-THERAPEUTIQUES EN 2016 NIVEAU 2 (TABLEAU 1 DETAILLE PAR CLASSE TECHNICO-THERAPEUTIQUE) .................................................................. 18 TABLEAU 3 - LES CLASSES TECHNICO-THERAPEUTIQUES EN 2016 - NIVEAU 3 .................................................................................................................................................................. 20 TABLEAU 4 - TOP 30 PAR QUANTITE D'ACTES EN 2016 ................................................................................................................................................................................................... 26 TABLEAU 5 - TOP 30 PAR MONTANT DE LA BASE DE REMBOURSEMENT (MONTANT REMBOURSABLE) EN 2016 .................................................................................................................... 30 TABLEAU 6 - TOP 30 PAR EVOLUTION DES MONTANTS PRESENTES AU REMBOURSEMENT ENTRE 2015 ET 2016 (POUR LES MONTANT > 20.000) ............................................................... 34

DEFINITIONS ET METHODE........................................................................................................................................................................................................................................ 36

1. DEFINITIONS ET INDICATEURS .............................................................................................................................................................................................................................. 38 2. CODAGE DE LA LPP ............................................................................................................................................................................................................................................ 40 TABLEAU 7- TABLEAU DE RECODAGE............................................................................................................................................................................................................................. 39

Tlcharger les donnes au format Excel :

TB LPP 2016

Dcembre 2017

Tableau de bord LPP 2016

DIRECTION DES ETUDES, DES REPERTOIRESDIRECTION DELEGUEE AUX POLITIQUES SOCIALES

ET DES STATISTIQUES

Directeur de la publication :Collge mdical:

Alain PELCDr Sandrine FARE

[email protected]@ccmsa.msa.fr

Dpartement "Rgulation, Evaluation

et Etudes en Sant":

Vronique DANGUY

[email protected]

Ralis par :

Annie NOURRY

[email protected]

Tristan HAGUES

[email protected]

mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]

Donnees 2016

Nombre de semainesNombre d'assursRpartitionQuantit de prothsesMontant dpens ()Evolution annuelle du montant dpensReste charge globalEvolution annuelle du reste charge global

de traitement()

1 4 semaines9071.70%20163115610,15113%110,531-52%

5 13 semaines2,5984.80%20153,116538,3739%227,94430%

14 26 semaines4,4088.20%20143,245494,122175,869

27 39 semaines4,0527.50%

40 semaines et plus41,91677.80%

Depense globale

DpenseRemboursableMontant remboursTicket modrateur Dpassement

(montant prsent au remboursement)(base de remboursement)

I- Maintien domicile405.1399.7347.552.35.4

II- Orthses, appareils de soutien et prothses externes405.692.668.124.4212.4

III- Produits implantables (en sus des soins en tablissements)7070.270.20.10

IV- Achats et rparations des fauteuils roulants9.98.38.301.6

TOTAL890.6570.8494.176.8219.4

Vue assurance maladie

TITRESQuantit dactesBase de remboursementMontant remboursTicketTaux de produits pris en charge 100%

(remboursable)modrateur

I- Maintien domicile8,045,253399.7347.552.356.20%

II- Orthses et prothses externes2,963,89592.668.124.411.20%

III- Produits implantables (en sus des soins en tablissements)126,46570.270.20.199.90%

IV- Achats et rparations des fauteuils roulants23,2598.38.3099.90%

TOTAL11,158,872570.849476.8

TITREQuantitBase de remboursementMontant remboursTicket modrateur

dactes(remboursable)

I- Maintien domicile2.40%3.00%3.00%3.40%

II- Orthses, appareil de soutien et prothses externes1.50%2.20%2.20%2.10%

III- Produits implantables (en sus des soins en tablissements)-0.40%0.20%0.30%-23.10%

IV- Achats et rparations des fauteuils roulants-2.20%-1.00%-0.90%0.00%

TOTAL2.10%2.50%2.40%3.00%

Vue assurs

TITRESQuantit dactesMontant prsent au remboursementMontant remboursReste chargeTaux de reste charge

I- Maintien domicile8,045,253405.1347.557.614.20%

II- Orthses, appareils de soutien et prothses externes2,963,895405.668.1337.583.20%

III- Produits implantables (en sus des soins en tablissements)126,4657070.2-0.00%

IV- Achats et rparations des fauteuils roulants23,2599.98.31.616.20%

TOTAL11,158,872890.6494.1396.544.50%

TITREQuantit dactesMontant prsent au remboursementMontant remboursReste charge

I- Maintien domicile2.40%3.30%3.00%4.30%

II- Orthses, appareils de soutien et prothses externes1.50%3.20%2.30%2.10%

III- Produits implantables (en sus des soins en tablissements)-0.40%0.00%0.40%-90.00%

IV- Achats et rparations des fauteuils roulants-2.20%-2.00%0.00%0.00%

TOTAL2.10%2.90%5.20%2.40%

Graph 1 11

Graph 12

Tableau 1

LibellsNb de bnficiaires ge% hommesTaux bnficiairesnb de prises en charge au titre d'une ALDQuantit de produitsQt d'actesMontant prsent au remboursementEvolution 2015Montant remboursableMontant remboursEvolution 2015Taux de rembour-sement.TMReste charge

moyenen ALDmdicaux20162016

(en %)

R- Appareil respiratoire159,75662.756.954.8692,2353,326,4551,089,462107,737,3873.30%107,461,22887,668,5822.30%81.619,792,64520,068,804

T- Maintien domicile106,29681.740.981895,2593,856,9441,057,36178,778,9672.20%78,603,05472,325,3731.90%926,277,6816,453,594

D- Dermatologie558,05659.651.339.51,350,7125,264,2042,426,46268,989,4911.90%67,460,10354,527,0883.10%80.812,933,01514,462,402

O- Appareil orthopdique externe652,95660.741.735.9466,913498,7731,174,08685,509,1162.80%66,859,23351,441,2152.70%76.915,418,01834,067,901

H- Mtabolisme106,46769.752.891.21,036,4892,645,3271,099,25844,334,4281.50%44,176,66443,157,5601.30%97.71,019,1041,176,868

A- Appareil digestif et abdomen119,37466.141.661.7942,3643,503,1391,242,68743,098,4543.30%42,604,74538,097,9113.20%89.44,506,8355,000,543

M- Implants orthopdiques22,67866.451.233.238,302112,589106,55642,139,568-0.10%42,206,35342,196,7360.10%1009,618-57,168

K- Aide la vie et fauteuils roulants (VPH)139,49373.341.162.1455,8141,710,529586,35542,244,3841.00%39,366,42235,968,2200.80%91.43,398,2026,276,164

S- Organes des sens et sphre ORL689,73656.947.127.3582,9912,177,3282,106,463324,179,5732.10%32,348,07120,705,9431.10%6411,642,128303,473,629

C- Systme cardio-vasculaire8,30777.366.77813,46518,01917,53826,326,1871.80%26,462,85126,420,2732.20%99.842,578-94,086

G- Appareil gnito-urinaire39,16959.940.247.3144,153351,990185,29619,132,7812.00%18,968,91117,578,6671.80%92.71,390,2441,554,114

Z- matriels divers19,91276.741.576.424,76626,8111,667,9401,652,1571,534,042-1058.90%92.9118,115133,898

E- Prothses rparatrices vise esthtique6,50667.218.671.95,5157,8737,7722,291,0260.60%1,634,8621,563,56723.80%95.671,294727,458

N- Neurologie6,70957.741.541.413,45758,55632,5761,022,3668.20%936,524790,7266.80%84.4145,798231,641

W - Ecart TIPS et Prise en charge Exceptionnelle2,58871.352.745.52,0834,740150,175149,817149,81787.30%1000358

Y- implants divers23869.55548.739420275,78374,58074,833-457.60%100.3-253950

Tableau 2

Niveau 2LibellsNb de bnfi-Age% hommesTaux bnfiNb de prises en charge au titre d'une ALDQuantit de produitsQt d'actesMontant prsent au rembour-Evolution 2015Montant rembour-Montant remboursEvolution 2015Taux de rembour-Ticket modra-Reste charge

ciaires moyenciairesmdicauxsement2016sable2016sementteur

en ALD

(en %)

R20Pression positive continue pour apne du sommeil54,21966.875.955.9340,0412,482,062616,00744,888,04612.80%44,881,36630,899,68812.60%6913,981,67813,988,358

R10Oxygnothrapie, prestation seule19,66984.844.689.7108,827443,947119,02929,137,590-7.20%29,120,78027,128,593-7.00%931,992,1862,008,997

R30Traitements respiratoires, autres prestations10,46775.859.287.686,603376,50498,88628,936,6531.10%28,866,20825,972,2371.30%902,893,9712,964,416

R02*appareil gnrateur d'arosol68,54464.146.953.9147,352230,3704,246,296-2.40%4,240,1633,440,454-1.90%81799,710805,842

R50Respiratoire : chambres dinhalation, implants et autres22,10628.350.623.95,62423,94223,785513,263-0.50%347,036220,5363.60%64126,500292,727

R01*appareils d'assistance respiratoire, oxygnothrapie domicile3,15271.763.467.23,7881,38515,5395,6747,074-1,4018,465

T30Lits mdicaux79,92784.339.483.8606,7192,792,671731,77046,648,9650.20%46,514,00942,258,8300.10%914,255,1794,390,135

T40Matriel anti-escarres, matelas et coussins53,67883.241.980.8132,359390,985154,13014,150,852-0.10%14,094,42812,783,5040.20%911,310,9241,367,348

T20Perfusion, systmes actifs, pompes implantes ou non5,314676188.948,338182,02050,7479,137,74519.00%9,164,1018,909,63818.10%97254,462228,107

T10Perfusion, systmes passifs22,02575.445.677.5101,187478,310113,9127,024,335-18.80%7,013,4476,590,339-22.10%94423,108433,997

T50Nutrition parentrale72767.765.397.56,65612,9586,8021,817,0701,817,0701,783,0639834,00734,007

D10Pansements542,36259.751.439.61,305,9294,947,1542,346,13762,148,6680.30%61,325,62849,439,7101.20%8111,885,91812,708,958

D20Dispositifs de contention, bandes43,79966.743.846.838,274316,99670,4926,466,89413.80%5,766,2674,783,09218.80%83983,1751,683,802

D01*articles de pansement8,26268.248.655.66,4599,782357,948894.00%352,278288,475776.20%8263,80469,474

D30Implants d'expansion ou de comblement2954.189.796.650545115,9808.30%15,93015,81211.70%99118168

O01*orthses petit appareillage415,20166.637.641.6319,844722,85836,316,344-1.30%28,554,81919,922,198-0.40%708,632,62216,394,147

O02*orthoprothses6,41351.955.457.416,19524,35312,996,4884.20%12,984,30512,984,2864.30%1001912,202

O20Orthses de srie248,74053.143.628.894,107415,245318,67621,219,6168.90%12,935,1148,861,07910.10%694,074,03512,358,537

O40Podo-orthses (Chaussures orthopdiques)7,49968.949.371.210,66314,90814,5926,592,790-2.20%6,439,5715,649,886-2.90%88789,686942,904

O50Dispositifs injectables viscolastiques31,73269.744.83612,72444,36435,1864,835,4983.90%4,403,7662,844,9143.10%651,558,8531,990,584

O03*Divers Orthses21,08046.746.418.56,55535,6582,555,31925.20%713,214457,35040.20%64255,8642,097,969

O30Orthoprothse sur mesure 24560.186.567.3217329321508,8093.50%505,877505,8772.90%10002,932

O10Dispositifs de maintien, protection et immobilisation20,70854.85029.26,60823,92722,442484,2520.50%322,566215,6276.40%67106,939268,625

H10Dispositifs pour autocontrle du diabte99,42070.252.792.7683,887896,352729,87727,361,912-0.20%27,359,68326,618,610-0.20%97741,072743,302

H20Dispositifs pour autotraitement du diabte (pompes, seringues, aiguilles)58,09670.551.694.9349,1931,737,313363,38416,838,0714.60%16,682,72116,431,0953.90%98251,627406,976

H30Dispositifs pour autotraitement et autocontrle autres que pour diabte2,45362.277.255.43,40911,6625,997134,445-6.00%134,260107,854-6.60%8026,40526,590

M20Implants orthopdiques du genou6,49371.346.337.29,61825,05024,91916,757,167-1.80%16,761,86016,758,901-1.80%1002,959-1,734

M30Implants orthopdiques de la hanche8,16575.348.442.314,23133,74033,73616,175,9690.90%16,232,47916,229,0131.30%1003,466-53,044

M60Implants orthopdiques autres, dont cheville, crne14,86964.65131.39,32738,17834,4214,036,9895.50%4,034,4444,033,5875.30%1008563,401

M10Implants orthopdiques (coude, paule, poignet, main et doigt)1,32672.129.737.71,7374,2674,2622,247,2600.50%2,252,7742,251,0590.80%1001,715-3,799

M40Implants orthopdiques du rachis1,33059.555.333.42,5308,8786,7871,713,560-0.40%1,712,9301,712,626-0.60%100304934

M50Greffons, substituts et implants osseux1,86164.45234.88592,4762,4311,208,623-5.60%1,211,8671,211,550-5.40%100317-2,927

A10Nutrition orale109,31365.338.859.7817,2262,806,4981,099,85826,991,9233.40%26,496,69322,546,6722.90%853,950,0214,445,251

A30Dispositifs pour stomies digestives12,57377.371.284.887,313174,29295,8558,961,3841.10%8,958,9728,538,0711.80%95420,901423,313

A20Nutrition entrale, poches et prestation1,97058.768.693.134,976522,34936,6466,349,0292.00%6,352,9636,216,9341.80%98136,030132,096

A01*Aliments destins des fins mdicales9416.546.893.62,84910,328796,11758.20%796,117796,23358.20%100-116-116

Niveau 2LibellsNb de bnfi-ciaires Age% hommesTaux bnfiNb de prises en charge au titre d'une ALDQuantit de produitsQt d'actesMontant prsent au rembour-Evolution 2015Montant rembour-Montant remboursEvolution 2015Taux de rembour-Ticket modra-Reste charge

moyenciairesmdicauxsement2016sable2016sementteur

en ALD

(en %)

K10Dispositifs daide la vie dont bquilles, dambulateurs119,85672.841.459.8269,510923,080357,75320,973,7701.90%19,795,05717,615,6792.00%892,179,3783,358,090

K20Fauteuils roulants, location et achat38,03077.341.176.6183,115783,979225,13020,063,911-0.90%18,424,98417,206,383-1.30%931,218,6012,857,528

K30Autres vhicules pour personnes handicapes (poussettes, tricycles)3,22882.33984.92,9243,4703,4151,189,1764.60%1,116,1671,116,1676.90%100073,009

K01*vhicules pour handicaps physiques18677.348.473.12655717,52830,21529,99199224-12,464

S40Audioprothses90,684795149.670,040190,175141,17678,302,8004.40%15,379,9619,866,163-2.10%645,513,79968,436,637

S10Optique, verres et montures566,85153.147.522.9381,6521,632,6851,684,429239,907,6581.00%12,729,1427,793,7720.70%614,935,371232,113,886

S30Ophtalmologie, implants84,40070.636.442.8121,694306,256259,6253,996,53520.90%3,033,4091,985,56821.40%651,047,8412,010,968

S50Sphre ORL2,33868.256.277.28,03434,8079,0111,000,3974.70%866,589853,1762.20%9813,412147,221

S20Optique, lentilles et aides visuelles6,04035.142.513.11,57113,40512,222972,1824.20%338,970207,2654.80%61131,705764,917

C40Stimulateurs cardiaques, botiers2,54383.360.4781,9972,5542,5547,529,020-9.40%7,519,7267,500,350-9.40%10019,37628,670

C10Implants vasculaires62676.755.9777401,3491,1047,381,62516.90%7,382,7877,382,37517.00%100411-751

C30Stents coronariens3,12874.37372.94,2725,9955,9644,768,35919.30%4,899,6044,898,86421.90%100740-130,505

C20Stents vasculaires2,14476.366.585.73,4694,1254,0184,047,458-13.90%4,064,2424,063,440-13.70%100801-15,982

C60Sondes dfibrillation et stimulation et autres2,16081.163.176.42,8583,8243,7612,460,2142.10%2,458,7762,437,7001.50%9921,07622,514

C50Dfibrillateurs implantables, botiers11172.283.892.8103111111103,032-17.80%103,032102,859-17.80%100173173

C70Dispositif d'assistance circulatoire mcanique (DACM)sssssssssssssss

G30Gnito-urinaire, matriel pour incontinence et sondage vsical19,45877.574.181139,979323,507161,79916,850,2863.40%16,724,52815,703,8173.40%941,020,7111,146,469

G20Gnito-urinaire, implants, dont grains d'iode, lectrostimulation10,61350.716.225.23,65717,61412,6661,758,623-8.10%1,721,2671,475,125-10.90%86246,142283,498

G10Dispositifs contraceptifs10,37534.40.14.851710,86910,831523,871-2.90%523,116399,725-5.70%76123,391124,146

E30Prothses oculaires et faciales1,67665.866.245.91,1682,4562,461770,92421.50%759,410756,05919.80%1003,35214,865

E10Prothses mammaires2,99069.30.378.52,5173,3123,188673,60523.70%608,990563,37050.50%9345,619110,235

E20Postiches1,98164.84.586.11,8032,1052,1011,007,0777.90%262,816240,593-6.00%9222,223765,566

E01*Prothses externes non orthopdiques3369.515.275.827224,546290.90%3,6463,54699.80%971001,001

N10Traitement externe de la douleur6,68157.741.341.413,43258,48532,505673,1117.90%587,268442,7374.60%75144,531230,374

N20Neurostimulateurs implants3954.969.238.5257171349,2568.60%349,256347,9899.60%1001,2671,267

W01*Ecart TIPS2,56471.252.845.22,0574,703147,03582.30%147,035147,03510000

W02*Prise en charge Exceptionnelle2475.837.570.826373,140-589.50%2,7822,7821000358

Y01*implants internes22068.35546.837918853,633-637.00%52,43152,683101-253950

Y02*implants mus par lectricit1883.455.672.2151422,150-273.00%22,15022,15010000

Z01*Autres matriels pour traitement domicile12,05679.636.97414,24715,398959,954-365.20%948,831881,0759367,75578,879

Z03*Matriels et appareils pour traitements divers8,02473.448.582.510,18810,992675,058-6278.30%674,124628,0179346,10847,041

Z02*Matriels et appareils de contention et de maintien 58269.742.350.333142132,9281134.50%29,20224,950854,2527,978

Tableau 3

Niveau 3LibellsNb de bn-ficiaires Age moyen% hommesTaux de bn-Nb de prises en charge au titre d'une ALDQuantit produitsQuantit actesMontant prsent au rembour-sementEvolution 2015Montant rembour-Montant remboursEvolution 2015Taux de rembourTicket modrateurReste charge

ficiaires en ALD2016sable2016sement

(en %)

R20APression positive continue pour apne du sommeil, prestation seule (forfait 9)53,93066.975.956.1339,9772,481,692615,63744,765,94012.70%44,759,32130,823,38512.50%68.913,935,93613,942,555

R30BTraitements respiratoires, prestations avec oxygne6,85178.453.78950,757214,23656,96519,161,1553.80%19,123,81317,658,5283.60%92.31,465,2851,502,627

R10AOxygnothrapie seule, long terme gazeux7,95983.346.691.958,784258,83264,21314,140,7505.80%14,121,07212,998,7446.10%92.11,122,3281,142,006

R10BOxygnothrapie seule, long terme liquide (forfait 2)2,98780.158.294.227,738105,44729,33611,411,554-18.10%11,414,61710,818,798-17.60%94.8595,819592,756

R30ATraitements respiratoires, autres prestations seules (ventilation)3,94871.268.185.535,846162,26841,9219,775,498-3.80%9,742,3958,313,709-3.40%85.31,428,6861,461,789

R02*Appareil gnrateur d'arosol68,54464.146.953.9147,352230,3704,246,296-2.40%4,240,1633,440,454-1.90%81.1799,710805,842

R10COxygnothrapie seule, court terme, seule (forfait 3)10,42487.439.286.622,30579,66825,4803,585,287-12.50%3,585,0913,311,052-12.30%92.4274,039274,235

R50Respiratoire : chambres dinhalation, implants et autres22,10628.350.623.95,62423,94223,785513,263-0.50%347,036220,5363.60%63.6126,500292,727

R20BOrthses d'avance mandibulaire36555.969.61764370370122,10523.40%122,04576,30324.90%62.545,74345,803

R01*Appareil d'assistance respiratoire, oxygnothrapie domicile3,15271.763.467.23,7881,38515,539-104.50%5,6747,074-102.60%124.7-1,4018,465



(en %)

T30ALits mdicaux, location78,29584.539.384.1582,3732,760,197699,83939,577,3191.00%39,562,88736,128,5810.80%91.33,434,3063,448,738

T40AMatelas, compresseurs et accessoires.39,71483.642.381.4110,747363,052127,66912,131,056-0.60%12,104,80511,000,085-0.20%90.91,104,7201,130,971

T10APerfusion, diffuseurs portables et divers22,02575.445.677.5101,187478,310113,9127,024,335-18.80%7,013,4476,590,339-22.10%94423,108433,997

T30CLits mdicaux, accessoires et rparations29,12282.444.776.424,16632,17831,6956,716,399-3.40%6,710,7795,908,168-3.10%88802,611808,231

T20BPerfusion, pompes externes, sauf insuline, consommables5,26766.961.188.831,92591,99533,6616,462,42516.50%6,488,1646,279,60615.40%96.8208,558182,819

T20APerfusion, pompes externes, sauf insuline1,87766.5599316,40590,01717,0782,643,28325.30%2,643,8992,597,99524.90%98.345,90445,288

T40BCoussins anti-escarres24,15283.14281.121,61227,93326,4612,019,7962.80%1,989,6231,783,4193.00%89.6206,204236,378

T50ANutrition parentrale 72767.765.397.56,65612,9586,8021,817,0701,817,0701,783,06398.134,00734,007

T30BLits mdicaux, achat22775.549.876.2180296236355,246-16.50%240,343222,081-14.80%92.418,262133,166

T20CPerfusion, systmes passifssssssssssssssss



(en %)

D10APansements primaires ou actifs260,77065.749.447.6475,1131,086,545758,16546,353,6441.30%46,262,33337,636,5922.30%81.48,625,7418,717,052

D10BPansements secondaires ou passifs425,05659.252.839.7463,6611,263,757898,6648,407,357-6.90%8,095,9516,371,700-5.90%78.71,724,2512,035,656

D20ABandes lastiques de contention43,52866.843.746.737,435314,69569,1556,278,60214.10%5,639,6884,675,48619.40%82.9964,2021,603,116

D10CPansements, dispositifs de fixation et de maintien242,29262.252.241.7292,5752,238,947547,5773,996,4140.40%3,576,6142,828,5071.50%79.1748,1071,167,907

D10DSets de pansements77,75562.856.44474,580357,905141,7313,391,2545.50%3,390,7292,602,9115.40%76.8787,818788,342

D01*articles de pansements8,26268.248.655.66,4599,782357,948352,278288,47581.963,80469,474

D20BVtements compressifs sur mesure29043.446.253.88392,3011,337188,2923.60%126,578107,605-2.70%8518,97380,686

D30Implants d'expansion ou de comblement2954.189.796.650545115,9808.30%15,93015,81211.70%99.3118168



(en %)

O01*orthses petit appareillage415,20166.637.641.6319,844722,85836,316,344-1.30%28,554,81919,922,198-0.40%69.88,632,62216,394,147

O02*orthoprothses6,41351.955.457.416,19524,35312,996,4884.20%12,984,30512,984,2864.30%1001912,202

O20AAttelles (correction orthopdique)115,75045.948.120.126,866134,768132,3907,805,5779.00%7,142,1614,690,7417.60%65.72,451,4203,114,835

O40Podo ortheses7,49968.949.371.210,66314,90814,5926,592,790-2.20%6,439,5715,649,886-2.90%87.7789,686942,904

O50Dispositifs injectables viscolastiques31,73269.744.83612,72444,36435,1864,835,4983.90%4,403,7662,844,9143.10%64.61,558,8531,990,584

O20CColliers cervicaux + CHST73,18370.131.952.248,009132,66487,5824,509,17322.20%3,541,9542,752,45921.90%77.7789,4951,756,714

O20BSemelles72,12548.44619.619,125147,54298,5288,877,8983.10%2,236,3281,405,795-1.10%62.9830,5327,472,103

O03*Divers Orthses21,08046.746.418.56,55535,6582,555,31925.20%713,214457,35040.20%64.1255,8642,097,969

O30APied restitution d'nergie24260.286.467.8211315307412,31512.50%409,383409,38311.70%1002,932

O10Dispositifs de maintien, protection et immobilisation20,70854.85029.26,60823,92722,442484,2520.50%322,566215,6276.40%66.9106,939268,625

O20DDiverses orthses (coque+therabite+montage appareil marche)14933.1555510727117626,9682.40%14,67212,0841.40%82.42,58814,884

O30BRotateur854.187.5756883,968101.30%3,9683,968101.30%100



(en %)

H10BAutocontrle du diabte, consommables99,03270.252.792.7651,656858,985692,60925,272,323-0.50%25,270,45724,648,124-0.40%97.5622,333624,198

H20AAutotraitement du diabte, pompes externes2,12244.654.998.537,011715,34637,9126,269,87410.60%6,114,9106,043,7088.10%98.871,202226,165

H20CAutotraitement du diabte, matriel d'injection pour pompes2,08044.755.298.635,481691,41536,3445,461,5633.40%5,461,6935,399,8533.80%98.961,84061,709

H20DMatriel d'injection (seringues, stylos, aiguilles)56,66771.251.594.8276,701330,552289,1285,106,635-0.90%5,106,1184,987,533-0.80%97.7118,585119,102

H10AAutocontrle du diabte, matriel, dont lecteurs de glycmie33,35768.652.586.732,23137,36737,2682,089,5894.00%2,089,2261,970,4862.00%94.3118,740119,104

H30Dispositifs pour autotraitement et autocontrle autres que pour diabte2,45362.277.255.43,40911,6625,997134,445-6.00%134,260107,854-6.60%80.326,40526,590



(en %)

M20Implants orthopdiques du genou6,49371.346.337.29,61825,05024,91916,757,167-1.80%16,761,86016,758,901-1.80%1002,959-1,734

M30Implants orthopdiques de la hanche8,16575.348.442.314,23133,74033,73616,175,9690.90%16,232,47916,229,0131.30%1003,466-53,044

M60Implants orthopdiques autres, dont cheville, crne14,86964.65131.39,32738,17834,4214,036,9895.50%4,034,4444,033,5875.30%1008563,401

M10Implants orthopdiques (coude, paule, poignet, main et doigt)1,32672.129.737.71,7374,2674,2622,247,2600.50%2,252,7742,251,0590.80%99.91,715-3,799

M40Implants orthopdiques du rachis1,33059.555.333.42,5308,8786,7871,713,560-0.40%1,712,9301,712,626-0.60%100304934

M50Greffons, substituts et implants osseux1,86164.45234.88592,4762,4311,208,623-5.60%1,211,8671,211,550-5.40%100317-2,927



(en %)

A10BNutriments pour supplmentation orale98,36168.242.364.6807,4772,645,4341,047,85825,012,3713.20%24,752,94321,268,7623.10%85.93,484,1813,743,609

A30AMatriel de stomie digestive12,28277.771.685.185,801171,28993,8758,540,3660.40%8,538,5618,140,2131.10%95.3398,348400,153

A20BNutrition entrale, prestations1,84059.268.893.915,01246,81915,7953,690,2731.20%3,689,3243,604,5501.00%97.784,77585,723

A20ANutrition entrale, consommables dont poches de nutriments1,837596993.119,964475,53020,8512,658,7563.10%2,663,6392,612,3842.90%98.151,25546,372

A10CNutrition, dispositifs divers, dont tire-laits11,09840.88.417.24,131140,26740,5671,815,63914.10%1,635,9071,191,2872.80%72.8444,621624,352

A01*Aliments destins des fins mdicales9416.546.893.62,84910,328796,11758.20%796,117796,23358.20%100-116-116

A30BStomie digestive, divers3335954.474.21,5123,0031,980421,01817.40%420,411397,85917.70%94.622,55323,160

A10AAliments sans gluten, soluts de rhydratation et autres51652.435.955.85,61820,79711,433163,913-37.90%107,84286,623-32.70%80.321,21977,290



(en %)

K10Dispositifs daide la vie dont bquilles, dambulateurs119,85672.841.459.8269,510923,080357,75320,973,7701.90%19,795,05717,615,6792.00%892,179,3783,358,090

K20AFauteuils roulants manuels, location30,45877.639.474.8166,235762,283205,34611,410,3221.50%11,267,23810,048,6370.00%89.21,218,6011,361,685

K20BFauteuils roulants manuels, achat8,53678.145.383.614,76519,22517,3965,378,128-5.40%4,848,6954,848,695-5.50%1000529,433

K20CFauteuils roulants lectriques1,2966363.5892,1152,4712,3883,275,462-1.20%2,309,0512,309,0512.60%1000966,411

K30Autres vhicules pour personnes handicapes (poussettes, tricycles)3,22882.33984.92,9243,4703,4151,189,1764.60%1,116,1671,116,1676.90%100073,009

K01*Vhicules pour handicaps physiques18677.348.473.12655717,52830,21529,991-171.40%99.3224-12,464



(en %)

S10BVerres plus de 18 ans473,71359.547.825.9256,096978,197976,066156,629,269-0.30%6,843,8424,232,092-1.60%61.82,611,750152,397,177

S30Ophtalmologie, implants84,40070.636.442.8121,694306,256259,6253,996,53520.90%3,033,4091,985,56821.40%65.51,047,8412,010,968

S10AVerres moins 18 ans71,8391145.13.75,683150,977150,67511,906,4505.10%2,241,8371,346,7553.00%60.1895,08210,559,695

S10CMontures moins 18 ans68,0431145.13.72,64669,93970,2018,452,3375.70%2,135,0571,282,2533.90%60.1852,8047,170,084

S10DMontures plus de 18 ans440,2505847.824.1116,060433,572484,04562,412,1171.90%1,476,133912,6840.90%61.8563,44961,499,433

S20ALentilles3,72746.136.512.98607,7767,401864,9852.40%299,208182,5582.50%61116,649682,427

S20BOptique divers, dont aides visuelles2,31817.452.213.77115,6294,821107,19721.70%39,76324,70725.80%62.115,05682,490

S10*Verres*2,59250.448.421.31,1673,442507,48532,27319,98761.912,286487,498

S40BAudioprothses, plus 20 ans24,23278.153.746.915,91940,29434,39159,075,040-0.20%8,087,1045,134,4240.70%63.52,952,68153,940,616

S40BAudioprothses, plus 20 ans27,93478.253.747.819,99448,49941,67971,012,8294.90%9,675,4966,100,8042.80%63.13,574,69264,912,025

S40CAudioprothses, accessoires et entretien68,47979.550.550.147,892140,55596,0465,435,6752.80%4,093,8982,579,485-5.90%631,514,4132,856,191

S40AAudioprothses, moins 20 ans6334644.1545611,1219801,830,514-16.50%1,532,4331,128,929-15.00%73.7403,504701,584

S50ADispositifs trachaux, prestation ventilation, prothses respiratoires et vocales1,9427156.982.37,37033,5558,027745,242-0.30%707,467695,2701.50%98.312,19749,972

S40*appareil lectronique de surdit1,90078.953.348.71,5932,47123,78278,13456,94572.921,190-33,162

S50BYoyos6359.75436.52587761,248-47.80%936687-55.30%73.5248560

S50CImplants ORL67454.860.743.65551,3231,099221,3945.40%187,976156,5587.90%83.331,41764,836

S50CImplants ORL45757.461.757.15741,013850205,687-14.60%179,873147,922-9.30%82.231,95157,766



(en %)

C10AValves cardiaques38384.746.588.83483893896,959,48015.70%6,959,5776,959,57715.80%1000-97

C40BStimulateurs cardiaques double chambre1,80882.657.873.91,3431,8121,8125,427,456-7.90%5,418,1625,401,723-8.00%99.716,43925,733

C30AStents coronariens actifs (mdicamenteux)2,70173.574.273.13,7105,1835,1554,330,47534.10%4,419,9784,419,23836.40%100740-88,763

C20AStents vasculaires (rnal, iliaque, fmoral)1,89276.264.286.52,9083,4063,3092,738,984-1.80%2,755,0822,754,287-1.30%100795-15,303

C60ASondes dfibrillation et stimulation2,06281.862.9772,7523,6643,6062,082,591-10.30%2,081,1532,080,845-10.30%1003081,746

C40AStimulateurs cardiaques simple chambre59185.867.587.35185935931,492,264-13.80%1,492,2641,489,327-13.70%99.82,9372,937

C20BStents vasculaires aortiques (abdominal, thoracique)28876.784.479.55617197091,308,474-31.60%1,309,1591,309,153-31.70%1006-679

C40CStimulateurs cardiaques triple chambre14982.265.891.3136149149609,300-10.90%609,300609,300-10.90%100

C30BStents coronariens inactifs54078.768.170.4562812809437,885-43.10%479,626479,626-38.30%100-41,742

C10DGreffons vasculaires et implants intracrniens22663.371.257.1376941696381,02932.20%382,057381,64532.40%99.9411-617

C60BCardio-vasculaire, autres implants, dont ECG10867.666.763.9106160155377,623329.70%377,623356,855336.10%94.520,76820,768

C50CDfibrillateurs implantables triple chambre6673.980.39764666664,152-18.50%64,15264,152-18.30%100

C10BCardio-vasculaire, plaques d'obturation et patchs1978.863.273.716191941,116274.60%41,15341,153274.90%100-37

C70Dispositif d'assistance circulatoire mcanique (DACM)sssssssssssssss

C50ADfibrillateurs implantables simple chambre2469.987.587.521242420,73620.00%20,73620,73620.00%100

C50BDfibrillateurs implantables double chambre2169.690.585.718212118,144-38.20%18,14417,971-38.80%99.1173173



(en %)

G30BGnito-urinaire, matriel pour sondage vsical9,83877.260.580.352,223176,54762,7408,505,4467.00%8,396,3917,892,6187.00%94503,772612,828

G30AGnito-urinaire, matriel pour incontinence14,52278.781.882.887,756146,96099,0598,344,840-0.10%8,328,1387,811,1990.00%93.8516,939533,641

G20BGnito-urinaire, lectrostimulation9,9674913.4222,99216,72311,783923,431-10.10%887,778641,988-16.70%72.3245,790281,443

G20AGnito-urinaire, implants dont grains d'iode64876.758.874.7665891883835,192-5.80%833,488833,137-5.90%1003512,055

G10Dispositifs contraceptifs10,37534.40.14.851710,86910,831523,871-2.90%523,116399,725-5.70%76.4123,391124,146



(en %)

E30Prothses oculaires et faciales1,67665.866.245.91,1682,4562,461770,92421.50%759,410756,05919.80%99.63,35214,865

E10AProthses externes mammaires2,87170.30.379.42,4133,1153,000610,15126.60%545,108499,62160.40%91.745,488110,531

E20Postiches1,98164.84.586.11,8032,1052,1011,007,0777.90%262,816240,593-6.00%9222,223765,566

E10BImplants mammaires12444.4058.910419718863,4541.30%63,88263,7501.40%99.8132-296

E01*prothses externes non orthopdiques3369.515.275.827224,546290.90%3,6463,54699.80%97.31001,001



(en %)

N10Traitement externe de la douleur6,68157.741.341.413,43258,48532,505673,1117.90%587,268442,7374.60%75.4144,531230,374

N20Neurostimulateurs implants3954.969.238.5257171349,2568.60%349,256347,9899.60%99.61,2671,267



(en %)

Z01*autres matriels pour traitement domicile12,05679.636.97414,24715,398959,954948,831881,07592.967,75578,879

Z03*matriels et appareil pour traitement divers8,02473.448.582.510,18810,992675,058674,124628,01793.246,10847,041

Z02*matriels et appareil de contention et de maintien58269.742.350.333142132,92829,20224,95085.44,2527,978



(en %)

W01*Ecart TIPS2,56471.252.845.22,0574,703147,035147,035147,03510000

W02*Prise en charge Exceptionnelle2475.837.570.826373,1402,7822,7821000358



(en %)

Y01*implant interne22068.35546.837918853,63352,43152,683100-253950

Y02*implant mu par lectricit1883.455.672.2151422,15022,15022,15010000

Source: MSA

Tableau 4

Part du produit au sein du titre en 2016Evolution 2015-2016

rang 2015rang 2016CodeLibellsQt de produitsQt d'actesMontant de la base du remboursementMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du remboursementMontant remboursQt de produitsQt d'actesMontant de base du remboursementMontant rembours

LPPmdicaux

TITRE I - Maintien domicile

111241763LIT MEDICAL, LIT STANDARD, LOCATION HEBDOMADAIRE, LIT ET ACCESSOIRES2,674,687677,67737,425,81234,105,33975.912.70%8.40%9.40%9.80%0.90%3.10%0.50%0.60%

221160792NUT ORALE, ADULTE, MEL POLY HYPERPROT. HYPERENERG, >OU= 200 ET OU= 200 ET OU = 100CM2, 50 SACHETS X 2196,389146,0712,001,2961,595,88542.60.90%1.80%0.50%0.50%-10.80%-9.80%-12.90%-12.60%

10101378031SPARADRAP NON ELASTIQUE, > OU = 2285CM2 & < 2500CM2189,627134,429350,739262,131280.90%1.70%0.10%0.10%-2.30%-1.90%-2.40%-1.90%

12111353752COMPRESSES NON TISSEES STERILES, > OU = 100CM2, BOITE DE 50 SACHETS X 2160,176113,2661,491,1311,215,47146.40.80%1.40%0.40%0.30%5.70%6.00%3.10%3.70%

18121132471SOLUTION HYALURONATE SODIUM 0,18%, HORUS, VISMED, FLACON 10 ML, B/1107,09893,1681,213,989798,08712.20.50%1.20%0.30%0.20%21.40%21.00%17.10%17.10%

13131145692NUT ORALE, ADULTE, MEL POLY HYPERPROT. HYPERENERG, >OU= 300 ET OU = 10000CM293,27681,382754,418590,88941.50.40%1.00%0.20%0.20%-7.60%-7.50%-7.70%-7.20%

16161298680VHP AVEC 1 ACCESSOIRE, LOCATION HEBDOMADAIRE, < OU = 52 SEMAINES306,62180,5055,037,1084,480,27170.51.50%1.00%1.30%1.30%-0.70%2.10%-0.80%-1.00%

19171217374LIT, COMPRESSEUR ET SURMATELAS PNEUMATIQUE, LOCATION HEBDOMADAIRE291,72176,9283,203,2753,055,76687.41.40%1.00%0.80%0.90%3.80%7.00%3.50%3.90%

22181330751COMPRESSES NON TISSEES STERILES, > OU= 56CM2 & < 100CM2, BOITE DE 50 SACHETS X 289,82276,619606,279451,81630.70.40%1.00%0.20%0.10%9.00%9.20%6.30%6.60%

15191332313BANDES EXTENSIBLES TISSEES OU TRICOTEES, 4 M A L'ETIRAGE ET LARGEUR 0,10 M1,057,51074,410845,475690,14143.65.00%0.90%0.20%0.20%-7.10%-7.60%-7.60%-6.90%

11201304736PANSEMENTS HYDROCELLULAIRES, >OU= 63 CM2 ET < 100 CM2, BOITE DE 1692,09070,3752,421,5881,830,61534.20.40%0.90%0.60%0.50%-47.50%-47.90%-47.50%-47.20%

23211255682VHP AVEC 1 ACCESSOIRE, LOCATION HEBDOMADAIRE, > 52 SEMAINES277,75569,3052,802,3942,575,37278.81.30%0.90%0.70%0.70%4.30%5.60%3.70%3.70%

20221314367PANSEMENTS VASELINES, > OU = 100CM2 & < 275CM2, BOITE DE 1098,36568,2251,457,4451,091,66630.90.50%0.80%0.40%0.30%-6.20%-5.00%-6.20%-6.20%

21231371508COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU = 56CM2 & < 100CM2, 50 SACHETS X 276,04267,064566,487418,02430.10.40%0.80%0.10%0.10%-6.10%-5.80%-8.40%-8.30%

24241326761COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU = 56CM2 &< 100CM2, 10 SACHETS X 281,19460,947159,182105,15713.50.40%0.80%0.00%0.00%-6.20%-4.70%-8.50%-8.40%

25251278654SOULEVE-MALADE, LOCATION HEBDOMADAIRE, > 32 SEMAINES223,01957,9992,412,1042,308,630881.10%0.70%0.60%0.70%5.50%7.00%5.40%5.40%

31261136894AUTOCONTROLE DU SUCRE DANS LE SANG, 50 BANDELETTES, CAPTEURS OU ELECTRODES111,38554,8662,117,3802,064,43192.80.50%0.70%0.50%0.60%14.40%12.10%14.30%14.50%

30271355685COMPRESSES NON TISSEES STERILES, > OU=56CM2 & < 100CM2, BOITE DE 10 SACHETS X 273,43754,797132,95587,83913.20.30%0.70%0.00%0.00%7.30%8.00%4.50%4.70%

27281296787CANNE METALLIQUE REGLABLE, AVEC APPUI ANTEBRACHIAL OU POIGNET EN T, A L'ACHAT91,90554,2741,111,594753,92220.70.40%0.70%0.30%0.20%1.00%0.50%0.90%0.50%

26291136581OXYGENOTHERAPIE A LONG TERME EN POSTE FIXE195,55549,0649,270,8618,527,83180.30.90%0.60%2.30%2.50%-6.80%-9.30%-6.80%-6.60%

29301338385COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU =100CM2, 10 SACHETS X 270,48948,738176,259119,22216.90.30%0.60%0.00%0.00%-4.90%-4.80%-7.30%-7.10%

Total des 30 premiers produits du titre I12,437,2294,938,478173,073,997146,110,34858.90%61.50%43.40%42.00%2.00%1.00%1.70%1.50%


rang 2015rang 2016CodeLibellsQt de produitsQt d'actesMontant de la base du remboursementMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du remboursementMontant remboursQt de produitsQt d'actesMontant de base du remboursementMontant rembours

LPPmdicaux

TITRE II - Orthses, prothses, appareils de soutien

11210000AORTHESE PETIT APPAREILLAGE722,85128,553,80719,921,59022.324.40%30.80%29.20%0.10%-0.10%-0.40%

222223342MONTURE , > OU = 18 ANS433,572433,4341,230,923759,2873.919.00%14.60%1.30%1.10%0.30%0.40%-0.60%-1.50%

332227038VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -8,00 A +8,00423,727422,8184,392,9252,721,5894.518.60%14.30%4.70%4.00%3.10%3.40%1.30%0.50%

442259966VERRE BLANC SIMPLE FOYER, >OU =18 ANS,CYLINDRE OU = 18 ANS, SPHERE DE -6,00 A +6,00126,634126,393291,986179,9093.85.60%4.30%0.30%0.30%-8.60%-8.40%-9.40%-10.00%

662290396VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -4,00 A +4,00112,261112,083821,600506,0473.84.90%3.80%0.90%0.70%-2.10%-2.00%-4.10%-4.90%

772200393VERRE BLANC SIMPLE FOYER, OU= 18 ANS,CYLINDRE OU= 200 ET OU= 300 ET 52 SEMAINES277,75569,3052,802,3942,575,37278.81.30%0.90%0.70%0.70%4.30%5.60%3.70%3.70%

29241148124INCONTINENCE, STOMIE URINAIRE, 30 POCHES DE JAMBE OU DE NUIT, 30 RACCORDS39,15034,0522,732,7862,513,46678.10.20%0.40%0.70%0.70%-0.80%-1.30%-0.90%-0.80%

32251166100AUTOCONTROLE, 200 LANCETTES POUR AUTOPIQUEUR NON REUTILISABLES STERILES188,158181,4472,682,3432,607,11892.80.90%2.30%0.70%0.80%1.50%1.40%1.30%1.40%

30261231782SOULEVE-MALADE, LOCATION HEBDOMADAIRE, < OU = 32 SEMAINES145,82038,9122,561,1702,427,42485.20.70%0.50%0.60%0.70%-5.70%-3.80%-5.60%-5.30%

36271130897PRESSION POSITIVE CONTINUE + OXYGENOTHERAPIE LONG TERME POSTE FIXE43,15710,6632,515,8472,172,50068.10.20%0.10%0.60%0.60%10.00%0.00%8.10%6.90%

34281139964INCONTINENCE MASCULINE, 30 ETUIS PENIENS EXTENSIBLES AVEC EMBOUT ADAPTABLE30,23724,4552,470,4462,317,43182.70.10%0.30%0.60%0.70%-0.30%-1.10%-0.40%-0.20%

15291304736PANSEMENTS HYDROCELLULAIRES, >OU= 63 CM2 ET < 100 CM2, BOITE DE 1692,09070,3752,421,5881,830,61534.20.40%0.90%0.60%0.50%-47.50%-47.90%-47.50%-47.20%

38301278654SOULEVE-MALADE, LOCATION HEBDOMADAIRE, > 32 SEMAINES223,01957,9992,412,1042,308,630881.10%0.70%0.60%0.70%5.50%7.00%5.40%5.40%

Total des 30 premiers produits du titre I12,034,4914,088,010232,745,333203,515,99157.30%50.80%58.50%58.60%10.80%6.60%-2.20%-1.90%


rang 2015rang 2016CodeLibellsQt de produitsQt d'actesMontant de la base du remboursementMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du remboursementMontant remboursQt de produitsQt d'actesMontant de base du rembour-Montant rembours

LPPmdicauxsement


11210000AORTHESE PETIT APPAREILLAGE722,85128,553,80719,921,59022.324.40%31.00%29.20%0.10%-0.10%-0.40%

22270000AORTHOPROTHESE24,35012,982,37412,983,1271000.80%14.00%19.10%1.20%4.30%4.30%

332335791AUDIOPROTHESE, APPAREIL DE CLASSE D, > OU = 20 ANS47,62540,9349,501,0815,987,8476.22.10%1.40%10.00%8.80%6.00%4.30%5.30%4.60%

542227038VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -8,00 A +8,00423,727422,8184,392,9252,721,5894.518.60%14.30%5.00%4.00%3.10%3.40%1.30%0.50%

452620400CHAUSSURES ORTHOPEDIQUES SUR MESURE, DE CLASSE B, LA PAIRE5,3985,3434,323,7803,894,28873.50.20%0.20%5.00%5.70%-0.90%-1.30%-1.50%-1.40%

662340119AUDIOPROTHESE, ENTRETIEN & REPARATIONS, ALLOCATION FORFAITAIRE ANNUELLE130,43486,8924,011,9512,525,9005.85.70%2.90%4.00%3.70%7.30%1.60%-5.50%-5.70%

772166740CHUT POUR AUGMENTATION DU VOLUME DE L'AVANT-PIED, L'UNITE97,74453,7952,975,9912,365,82846.74.30%1.80%3.00%3.50%26.60%23.70%26.00%26.20%

882210546MONTURE , < 18 ANS69,93969,9062,126,6471,277,0430.23.10%2.40%2.00%1.90%3.60%3.60%3.50%3.50%

992140455ORTHESE PLANTAIRE, AU-DESSUS DU 37125,11383,4441,806,6931,134,0176.65.50%2.80%2.00%1.70%1.30%-2.20%-1.00%-1.00%

10102689974CHAUSSURES ORTHOPEDIQUES SUR MESURE, DE CLASSE A, LA PAIRE2,2312,2051,619,4811,312,14250.60.10%0.10%2.00%1.90%-6.90%-7.40%-7.60%-7.10%

11112355084AUDIOPROTHESE, APPAREIL DE CLASSE D, < 20 ANS1,1059671,518,6831,118,15930.30.00%0.00%2.00%1.60%-12.00%-12.50%-11.80%-11.90%

12122200393VERRE BLANC SIMPLE FOYER, OU =18 ANS,CYLINDRE OU = 18 ANS, SPHERE DE -4,00 A +4,00112,261112,083821,600506,0473.84.90%3.80%1.00%0.70%-2.10%-2.00%-4.10%-4.90%

2121200000ADIVERS ORTHESES35,658713,214457,3508.61.20%1.00%0.70%24.30%34.90%36.10%

22222261874VERRE BLANC SIMPLE FOYER, < 18 ANS, SPHERE DE -6,00 A +6,0043,67543,604525,573315,3570.11.90%1.50%1.00%0.50%1.00%1.30%1.00%0.90%

23232182755COR, ORTHO,, MAIN-POIGNET, ORTHESE STATIQUE, POIGNET-RIGIDE9,0738,906377,391242,89610.40.40%0.30%0.00%0.40%11.30%10.70%11.20%11.00%

25242251545LENTILLE DE CONTACT, FORFAIT ANNUEL, PAR OEIL APPAREILLE7,7767,360297,056181,0022.90.30%0.20%0.00%0.30%4.90%4.00%2.80%2.40%

24252203240VERRE BLANC SIMPLE FOYER, > OU = 18 ANS, SPHERE DE -6,00 A +6,00126,634126,393291,986179,9093.85.60%4.30%0.00%0.30%-8.60%-8.40%-9.40%-10.00%

27262139943CORRECTION ORTHOPEDIQUE, MAIN, ATTELLE MP, FLEXION, POUCE ABDUCTION6,6166,385285,673183,62310.40.30%0.20%0.00%0.30%15.00%14.80%14.40%14.00%

26272183855CHUT A DECHARGE DE L'AVANT-PIED, L'UNITE8,8017,819266,203184,35822.80.40%0.30%0.00%0.30%6.60%5.80%5.90%5.70%

29282161530CORRECTION ORTHOPEDIQUE, PIED, ATTELLE MONTEE SUR CHAUSSURES4,1464,127265,384178,02617.80.20%0.10%0.00%0.30%12.40%13.60%11.80%11.90%

30292158449ORTHESE PLANTAIRE, MONOBLOC EN RESINE COULEE, MOULAGE DU PIED8,6755,912237,670154,29611.90.40%0.20%0.00%0.20%2.00%3.70%1.90%2.00%

33302591583PROTHESE OCULAIRE, RENOUVELLEMENT AVEC PRISE D'EMPREINTE252252212,940212,9401000.00%0.00%0.00%0.30%2.00%2.00%2.00%2.00%

Total des 30 premiers produits du titre II2,150,1602,788,58687,289,31463,860,78894.30%94.00%92.00%93.90%2.20%1.00%2.00%2.00%



LPPmdicauxsement

TITRE III Produits implantables (en sus des soins raliss en tablissement)

113151047GENOU, IMPLANT FEMORAL, BICONDYLIEN, NON CIMENTE3,0113,0114,492,4534,491,53499.92.30%2.40%6.40%6.40%-7.80%-7.80%-8.70%-8.70%

223489875STIMULATEUR CARDIAQUE DOUBLE CHAMBRE, TYPE DDDR1,4891,4894,359,4024,347,09098.61.10%1.20%6.20%6.20%-6.60%-6.60%-9.00%-8.90%

333165517HANCHE, TIGE STANDARD, COL INCLUS, DROITE, MODULAIRE NON CIMENTEE4,7194,7164,177,3594,176,46199.93.50%3.70%5.90%6.00%-3.50%-3.50%4.40%4.40%

443120041HANCHE, COTYLE STANDARD, MODULAIRE, METAL-BACK, SANS INSERT, NON CIMENTE6,1686,1683,916,7963,915,90499.84.60%4.90%5.60%5.60%-6.10%-6.10%1.50%1.50%

553299070BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, EDWARDS SAPIEN 3 + COMMANDER2082083,806,8893,806,8891000.20%0.20%5.40%5.40%22.40%22.40%14.70%14.70%

663127942GENOU, IMPLANT FEMORAL, BICONDYLIEN, CIMENTE2,3492,3493,028,5133,028,2611001.80%1.90%4.30%4.30%10.70%10.70%9.30%9.30%

773183194IMPLANT ENDOVASCULAIRE DIT STENT, AORTIQUE, RENAL, ILIAQUE OU FEMORAL3,1553,0642,492,4802,491,68599.82.40%2.40%3.60%3.60%1.00%0.80%-0.80%-0.80%

883152319GENOU, IMPLANT TIBIAL BICOMPARTEMENTAL, EMBASE METALLIQUE, CIMENTEE3,2933,2932,407,7372,407,74099.92.50%2.60%3.40%3.40%2.20%2.20%0.90%0.90%

93267005BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, MEDTRONIC, COREVALVE EVOLUT R,1301302,362,3992,362,3991000.10%0.10%3.40%3.40%,,,,

9103181870GENOU, IMPLANT BICOMPARTIMENTAL OU INSERT TIBIAL EN POLYETHYLENE SEUL5,8615,8612,105,3152,105,01999.94.40%4.60%3.00%3.00%-0.50%-0.50%-1.80%-1.80%

10113191756GENOU, IMPLANT TIBIAL BICOMPARTIMENTAL, EMBASE METALLIQUE, NON CIMENTEE2,0692,0691,929,0781,928,50499.91.60%1.60%2.70%2.70%-4.70%-4.70%-5.60%-5.60%

13123111390HANCHE, TETE OU TETE A JUPE, CERAMIQUE4,7414,7411,739,4201,739,12099.93.60%3.70%2.50%2.50%-5.60%-5.50%2.20%2.30%

12133416340SONDES STIM ATRIALE OU VENTRICULAIRE DROITE HORS VDD, BIPOLAIRES3,2333,1751,645,3101,645,00299.92.40%2.50%2.30%2.30%-7.00%-6.60%-11.30%-11.30%

14143442750STIMULATEUR CARDIAQUE SIMPLE CHAMBRE FREQUENCE ASSERVIE, TYPE SSIR (VVIR / AAIR)5125121,253,5061,250,56998.80.40%0.40%1.80%1.80%-9.20%-9.20%-11.40%-11.30%

15153199321HANCHE, TIGE STANDARD, COL INCLUS, DROITE, MODULAIRE, CIMENTEE1,6721,6721,231,6071,231,30699.71.30%1.30%1.80%1.80%-6.90%-6.90%0.50%0.60%

17163140150HANCHE, INSERT EN CERAMIQUE2,9272,9271,078,5811,078,50699.92.20%2.30%1.50%1.50%-1.90%-1.70%6.10%6.10%

19173197753OSTEOSYNTHESE, SYSTEME D'ANCRAGE TENDINEUX OU LIGAMENTAIRE, NON RESORBABLE9,0088,1821,075,8891,075,67299.96.80%6.50%1.50%1.50%12.30%12.80%10.50%10.50%

16183187045EPAULE, TIGE HUMERALE STANDARD, MODULAIRE9139121,007,8081,007,14299.70.70%0.70%1.40%1.40%0.90%0.80%-1.00%-1.00%

18193174960HANCHE, TIGE ANATOMIQUE, COL INCLUS, NON CIMENTEE893893935,204934,99099.90.70%0.70%1.30%1.30%-11.60%-11.60%-4.40%-4.40%

20203190857OSTEOSYNTHESE, SYSTEME D'ANCRAGE TENDINEUX OU LIGAMENTAIRE, RESORBABLE4,9994,496912,667912,6291003.80%3.60%1.30%1.30%10.60%9.40%9.10%9.10%

37213426550STIMULATEUR CARDIAQUE DOUBLE CHAMBRE FREQ, ASSERV,, BIOTRONIK, ELUNA 8 DR-T,262262898,947896,20298.50.20%0.20%1.30%1.30%167.30%167.30%164.30%163.50%

21223137283RACHIS, IMPLANT ANCRAGE, VIS PEDICULAIRE NON CERVICALE4,4243,024784,318784,1791003.30%2.40%1.10%1.10%-1.60%0.00%-4.20%-4.20%

22233107916HANCHE, TETE OU TETE A JUPE, METALLIQUE3,5363,536748,182747,97199.72.70%2.80%1.10%1.10%-5.40%-5.40%2.20%2.20%

23243168042HANCHE, COTYLE DE RECONSTRUCTION, MODULAIRE, METAL-BACK, SANS INSERT NON CIMENTE590590636,333636,3331000.40%0.50%0.90%0.90%-10.50%-10.50%-3.00%-3.00%

24253104987GENOU, IMPLANT FEMORAL DE REPRISE BICONDYLIEN, CIMENTE410410578,669578,65399.50.30%0.30%0.80%0.80%3.00%3.00%0.90%0.90%

27263128976RACHIS, CAGE INTERSOMATIQUE OU EQUIVALENT1,1361,062535,330535,23199.90.90%0.80%0.80%0.80%3.90%3.90%0.90%0.90%

28273157570GENOU, IMPLANT PATELLAIRE EN POLYETHYLENE SEUL3,6253,625482,332482,24899.92.70%2.90%0.70%0.70%2.00%2.00%0.10%0.10%

26283184093IMPLANT POUR PLASTIE ENDOCANALAIRE, EXPANSIBLE, METALLIQUE545537476,814476,46299.60.40%0.40%0.70%0.70%-11.10%-10.50%-11.40%-11.40%

31293175830OSTEOSYNTHESE, VIS D'INTERFERENCE, RESORBABLE, LIGAMENTOPLASTIE1,8781,781421,678421,81499.81.40%1.40%0.60%0.60%-0.70%-1.90%-2.20%-2.10%

29303105811GENOU, EMBASE DE REPRISE, CIMENTEE395395418,337418,11399.70.30%0.30%0.60%0.60%-3.40%-3.40%-5.00%-5.00%

Total des 30 premiers produits du titre III78,15175,09051,939,35451,913,63059.00%59.30%73.90%74.00%-8.10%-8.20%1.00%1.00%



LPPmdicauxsement

TITRE IV - Achats et rparations de fauteuils

114118193VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER INCLINABLE4,5244,4972,709,3832,709,38310018.00%19.30%32.60%33.00%-5.80%-5.60%-5.60%-5.60%

224122757VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, VERIN PNEUMATIQUE2992991,173,3441,173,3441001.20%1.30%14.10%14.00%5.30%5.30%4.90%4.90%

334107723VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE1,8921,8921,057,9491,057,9491007.50%8.10%12.70%13.00%1.90%2.40%2.70%2.70%

444252810VHP, POUSSETTE OU FAUTEUIL NON REGLABLE, DOSSIER OU SIEGE RIGIDES OU NON2,2032,159770,957770,9571008.80%9.30%9.30%9.00%14.20%11.90%12.00%12.10%

554130136VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, PLATINES CRANTEES160160558,072558,0721000.60%0.70%6.70%7.00%-12.10%-12.10%-10.70%-10.50%

664342654VHP, PROPULSION MANUELLE, REPOSE-JAMBE DROIT OU GAUCHE, REPOSE-PIED ARTICULE3,1022,051327,892327,89210012.30%8.80%3.90%4.00%-11.90%-11.70%-12.00%-12.00%

774233570VHP, CHASSIS ROULANT DESTINE A RECEVOIR LE SYSTEME DE SOUTIEN DU CORPS908908239,544239,5441003.60%3.90%2.90%3.00%-1.10%-0.80%-1.00%-0.90%

984307994VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION COMPOSANTS ELECTRIQUES571559142,103142,1031002.30%2.40%1.70%2.00%5.90%7.70%4.90%4.90%

894375116VHP, PROPULSION MANUELLE, PLIANT, COUSSIN DE SIEGE OU DE DOSSIER AVEC HOUSSE3,8983,517136,102136,10210015.50%15.10%1.60%2.00%-4.70%-4.20%-4.80%-4.70%

11104168966VHP, PROPULSION ELECTRIQUE, VERTICALISATEUR ELECTRIQUE2323119,312119,3121000.10%0.10%1.40%1.00%-8.00%-8.00%-4.30%-4.30%

12114302152VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, AUTRES REPARATIONS DONT SELLERIE1,4181,355105,273105,2731005.60%5.80%1.30%1.00%-2.10%-3.20%-9.60%-9.60%

13124325302VHP, PROPULSION MANUELLE, APPUI-TETE1,6321,630103,476103,4761006.50%7.00%1.20%1.00%-7.80%-7.80%-7.80%-7.70%

10134327382VHP, PROPULSION MANUELLE, GOUTTIERE DROITE OU GAUCHE80461195,96395,9631003.20%2.60%1.20%1.00%-24.10%-22.50%-24.10%-24.00%

14144122473VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE, ARTICULATION MEDIANE14614688,15388,1531000.60%0.60%1.10%1.00%-7.00%-7.00%-7.00%-7.00%

15154339681VHP, PROPULSION ELECTRIQUE, BOITIER DE COMMANDE PERSONNALISE11711783,56883,5681000.50%0.50%1.00%1.00%-0.80%-0.80%-0.80%-0.80%

20164300348VHP, PROPULSION MANUELLE, DISPOSITIF DE PROPULSION PAR MOTEUR ELECTRIQUE353577,64077,6401000.10%0.20%0.90%1.00%118.80%118.80%121.90%121.90%

16174307824VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, REPARATION DE ROUES1,1091,02962,96662,9661004.40%4.40%0.80%1.00%3.60%2.00%-4.50%-4.50%

19184348622VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, HORS ROUES ET COMPOSANTS ELECTRIQUES70066149,52749,5271002.80%2.80%0.60%1.00%18.40%16.60%9.70%9.70%

17194222803VHP, TRICYCLE A PROPULSION MANUELLE OU PODALE, > OU = 38 CM ET < 90 CM787849,11249,1121000.30%0.30%0.60%1.00%-22.00%-22.00%-23.50%-23.50%

28204111854VHP, PROPULSION ELECTRIQUE, A DOSSIER NON INCLINABLE171745,94845,9481000.10%0.10%0.60%1.00%183.30%183.30%183.30%183.30%

18214371555VHP, PROPULSION MANUELLE, PLIANT, SYSTEME DE CONDUITE A DOUBLE MAIN COURANTE15815842,77042,7701000.60%0.70%0.50%1.00%-15.50%-15.50%-15.70%-15.70%

5322400000AVEHICULES POUR HANDICAPES PHYSIQUES5730,21529,99199.70.20%0.40%0.00%-1050.00%-2060.40%-2028.40%

23234389845VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION DE ROUES53350130,01630,0161002.10%2.20%0.40%0.00%13.20%10.10%3.50%3.60%

21244179540VHP, PROPULSION MANUELLE, POUR ACTIVITES PHYSIQUES ET SPORTIVES535329,80229,8021000.20%0.20%0.40%0.00%0.00%0.00%0.60%0.60%

24254134364VHP, PROPULSION MANUELLE, EVOLUTIF, POUR ENFANT A PARTIR DE 18 MOIS222220,30620,3061000.10%0.10%0.20%0.00%-4.30%-4.30%-8.20%-8.20%

22264183434VHP, PROPULSION MANUELLE, VERTICALISATEUR ELECTRIQUE8819,49019,4901000.00%0.00%0.20%0.00%-33.30%-33.30%-33.00%-33.00%

25274329040VHP, PROPULSION MANUELLE, TABLETTE COMPLETE AVEC SON MONTAGE25225219,34419,3441001.00%1.10%0.20%0.00%-0.80%-0.80%-0.90%-0.90%

26284261051VHP, POUSSETTE MULTIREGLABLE & EVOLUTIVE, < 16 ANS191918,28218,2821000.10%0.10%0.20%0.00%0.00%0.00%0.20%0.20%

27294359293VHP, PROPULSION MANUELLE, PLIANT, SYSTEME DE CONDUITE A LEVIER LATERAL323213,72313,7231000.10%0.10%0.20%0.00%-17.90%-17.90%-17.90%-17.90%

30304255116VHP, POUSSETTE OU FAUTEUIL, < 16 ANS, DOSSIER OU DOSSIER ET SIEGE INCLINABLES232313,20713,2071000.10%0.10%0.20%0.00%15.00%15.00%15.00%15.00%

Total des 30 premiers produits du titre IV24,73622,8698,233,4368,233,21398.30%98.10%99.10%99.00%-3.80%-3.00%-1.40%-1.30%

Tableau 6

Part du produit au sein du titre en 2016

CodeLibellsQt de produitsQt d'actesMontant prsent au rembourEvolution 2015Montant rembour-Montant rembours% de produit PEC 100%Qt de produitsQt d'actes% montant prsent au rembour-Montant de la base du remboursementMontant rembours

LPPmdicauxsement2016sablesement

TITRE I - Maintien domicile

1165507SOLUTION A USAGE OPHTALMIQUE, ALCON, SYSTANE ULTRA, FLACON MULTIDOSE 10 ML12,23811,303153,824417332%127,21782,97711.60.10%0.10%0.00%0.00%0.00%

1314261PANSEMENTS HYDROCOLLOIDES, >OU= 156 CM2 ET < 200 CM2, BOITE DE 101,01782540,117101952%39,99032,91451.40.00%0.00%0.00%0.00%0.00%

1107711NUT ORALE, ENFANT > 1 AN, NUTRICIA, NEOCATE ADVANCE, BTE 400G,1,41623167,30016725%59,47244,40232.90.00%0.00%0.00%0.00%0.00%

1187331NUT ORALE, ENFANT DE 1 A 18 ANS, NUTRICIA, KETOCAL, B/1,6265640,49615550%40,49637,08080.40.00%0.00%0.00%0.00%0.00%

1194220AUTO/HETEROSONDAGE, SET SONDE STERIL + POCH, COLOPLAST, SPEEDICATH COMPACT, B/205,3071,151434,9222340%430,230390,33970.60.00%0.00%0.10%0.10%0.10%

1130816AUTO/HETEROSONDAGE, SONDES VESIC STERILES, COLOPLAST, SPEEDICATH COMPACT, B/3017,9964,0601,641,6832121%1,638,2851,514,13275.90.10%0.10%0.40%0.40%0.40%

1112161DEFIBRILLATEUR CARDIAQUE EXTERNE PORTABLE, ZOLL, LIFEVEST 40009287292,5601433%292,560277,29684.30.00%0.00%0.10%0.10%0.10%

130000AMATERIELS ET APPAREILS POUR TRAITEMENT DIVERS10,992675,058996%674,124628,01776.50.10%0.20%0.20%0.20%

1133163FRA-108, PPC, APNEE SOM, 9,4 + OXYG OLT 2,18 CHART SEQ, ECLIPSE 342110236,000953%36,00032,75080.40.00%0.00%0.00%0.00%0.00%

1132442VENTILATION ASSISTEE, < 12 HEURES + SCALEO, INOGEN ONE G31,284380138,494664%138,285130,15180.40.00%0.00%0.00%0.00%0.00%

1311943PANSEMENTS HYDROCELLULAIRES, 300 CM2, URGO, URGOSTART BORDER, B/1651339094,041632%94,03276,85052.80.00%0.00%0.00%0.00%0.00%

1327186PANSEMENTS HYDROCELLULAIRES, 64 CM2, URGO, URGOSTART BORDER, B/164,3743,404174,882602%174,879136,95141.50.00%0.00%0.00%0.00%0.00%

140000AARTICLES DE PANSEMENT9,782357,948525%352,278288,475380.10%0.10%0.10%0.10%

1301070PANSEMENTS HYDROCELLULAIRES, 400 CM2, URGO, URGOSTART BORDER, B/1623616757,092496%57,09247,46353.80.00%0.00%0.00%0.00%0.00%

1365270PANSEMENTS HYDROCELLULAIRES, 169 CM2, URGO, URGOSTART BORDER, B/162,8232,221293,227452%293,197234,70345.80.00%0.00%0.10%0.10%0.10%

1172513FRA-129, PPC, APNEE SOM, 9,4 + OXYG OLT 2,19 SCALEO INOGEN ONE G396520382,663451%82,06570,170700.00%0.00%0.00%0.00%0.00%

120000AMATERIELS ET APPAREILS DE CONTENTION ET DE MAINTIEN42132,928445%29,20224,95036.10.00%0.00%0.00%0.00%

1108202DISPOSITIF ASSISTANCE CIRCULAT, LOC MAINTENANCE, MENSUEL, THORATEC, HEARTMATE II572234,086418%32,29232,2921000.00%0.00%0.00%0.00%0.00%

1349934PANSEMENTS INTERFACE, 300 CM2, URGO, URGOSTART INTERFACE, B/16,665394122,067368%122,067102,94060.40.00%0.00%0.00%0.00%0.00%

1103156PRESSION POSITIVE CONTINUE + PHILIPS, ULTRAFILL2639022,465344%22,46520,83185.90.00%0.00%0.00%0.00%0.00%

1118904PRESSION POSITIVE CONTINUE + PHILIPS, SIMPLYGO56313948,142319%48,14240,07059.70.00%0.00%0.00%0.00%0.00%

1138315OXYGENOTHERAPIE A LONG TERME, DEAMBULATION, SCALEO, INOGEN ONE G3,6,9871,646537,278297%536,104499,67383.30.00%0.00%0.10%0.10%0.10%

1218280ESCARRES, SURMATELAS AIR MOTORISE, ASKLE, AXTAIR ONE, FORFAIT LOC HEBDOMADAIRE13,8964,003111,009295%111,007105,73287.40.10%0.00%0.00%0.00%0.00%

1343311PANSEMENTS INTERFACE, 156 CM2, URGO, URGOSTART INTERFACE, B/16,2,5521,903244,926279%244,889203,24354.20.00%0.00%0.10%0.10%0.10%

1126708VENTILATION ASSISTEE, < 12 HEURES + DEVILBISS HEALTHCARE, IFILL69516075,331266%75,33169,56578.10.00%0.00%0.00%0.00%0.00%

1171063DIGESTIF, SET, COUPLE ADHESIF, POCHE FERMEE, STANDARD18512123,205262%23,20323,02997.50.00%0.00%0.00%0.00%0.00%

1158737OXYGENO, PEC DE LA DYSPNEE PATIENTS SOINS PALLIATIFS OU FIN DE VIE,ODYSP 3,3021,9635,631988,398261%988,362914,08378.80.10%0.10%0.20%0.20%0.30%

1120947NUT, ORALE, HYDROLYSAT PROT+TCM, ENFANT, POUDRE, 17 RATIONS DE 200 ML3,03794765,741230%45,74627,7440.80.00%0.00%0.00%0.00%0.00%

1131170PERFUSION, POMPE EXTERNE A INSULINE, LOCATION ET PRESTATION, FORFAIT JOURNALIER,688,52836,1585,786,487225%5,786,2535,721,61397.93.30%0.40%1.40%1.40%1.60%

1228857ESCARRES, COUSSIN PNEUMATIQUE, CLASSE II, RECFRANCE, PROFIL'AIR,11311320,861222%20,84919,81585.80.00%0.00%0.00%0.00%0.00%

Total des 30 premiers produits du titre I788,81297,10212,693,23112,616,11411,830,2503.70%0.90%2.80%2.80%3.10%


CodeLibellsQt de produitsQt d'actesMontant prsent au rembour-Evolution 2015Montant rembour-Montant rembours% de produit PEC 100%Qt de produitsQt d'actes% montant prsent au rembour-Montant de la base du remboursementMontant rembours



220000CVERRES3,372501,260877.20%29,71818,31840.10%0.10%0.00%0.00%

220000BMONTURES1,616222,733663.50%13,0338,2634.10.10%0.10%0.00%0.00%

2326438PROTHESE OSTEO-INTEGREE, COCHLEAR, BAHA 4, PROCESSEUR,8831,300353.60%7,2006,84087.50.00%0.00%0.00%0.00%0.00%

2541450PROTHESE OCULAIRE PROVISOIRE, TEST DE RECOUVREMENT, TEST DE TOLERANCE363621,916263.90%5,6345,6341000.00%0.00%0.00%0.00%0.00%

2593257VERRE SCLERAL PERMEABLE OXYGENE, LAO, SPOT, PREMIERE MISE434334,420180.80%34,42034,4201000.00%0.00%0.00%0.00%0.10%

2752187PIED RESTITUTION ENERGIE, CLASSE III, OTTO BOCK, TRITON232363,536150.90%63,53663,5361000.00%0.00%0.00%0.10%0.10%

2346441AUDIOPROTHESE, LUNETTES AUDITIVES, > OU = 20 ANS474469,249133.70%9,3866,27118.20.00%0.00%0.00%0.00%0.00%

2731854PIED RESTITUTION ENERGIE, CLASSE III, OSSUR, VARI-FLEX XC101028,47668.70%28,47628,4761000.00%0.00%0.00%0.00%0.00%

2531807PROTHESE OCULAIRE DEFINITIVE DE RECOUVREMENT AVEC PRISE D'EMPREINTE272725,33462.20%24,70824,7081000.00%0.00%0.00%0.00%0.00%

2545459PROTHESE OCULAIRE PALPEBRO-ORBITAIRE, SUR DEVIS8832,87856.50%38,20338,2031000.00%0.00%0.00%0.00%0.10%

2304997PROTHESE OSTEO-INTEGREE, PRODITION, PONTO, PROCESSEUR141450,48751.90%12,60012,24094.40.00%0.00%0.00%0.00%0.00%

220000JVERRES UNIFOCAUX OP6 (CMU)10820,80150.20%2,6501,6798.30.00%0.00%0.00%0.00%

2350922IMPLANT COCH OU TRONC CEREBRAL, PROCESSEUR, FORFAIT ANNUEL ACCESSOIRES34127321,90049.30%19,00919,0091000.00%0.00%0.00%0.00%0.00%

220000GVERRES UNIFOCAUX OP3 (CMU)77462,70630.40%5,2163,2113.90.00%0.00%0.00%0.00%

2594044PROTHESE OCULAIRE DE RECOUVREMENT, RENOUVELLEMENT AVEC PRISE D'EMPREINTE626258,84428.90%56,96656,9661000.00%0.00%0.00%0.10%0.10%

2285136MATERIELS POUR AMBLYOPIE, SYSTEME DE REEDUCATION, LA BOITE DE 50, PETITE TAILLE1,7451,66547,68027.50%16,0199,7772.60.10%0.10%0.00%0.00%0.00%

2166740CHUT POUR AUGMENTATION DU VOLUME DE L'AVANT-PIED, L'UNITE97,74453,7953,738,68927.30%2,975,9912,365,82846.74.30%1.80%0.90%3.20%3.50%

220000FVERRES UNIFOCAUX OP2 (CMU)13,814374,79127.10%50,76131,3453.90.50%0.10%0.10%0.00%

260000ACHAUSSURES ORTHOPEDIQUES12441,27627.00%42,26442,13666.30.00%0.00%0.00%0.10%

220000KMONTURE (CMU)15,938637,99325.60%45,71528,45650.50%0.20%0.00%0.00%

2156864CORRECTION ORTHOPEDIQUE, MAIN, ATTELLE DIGITALE, EXTENSION ASSISTEE96580321,09324.70%16,06310,80417.50.00%0.00%0.00%0.00%0.00%

220000EVERRES UNIFOCAUX OP1 (CMU)5,961129,95623.90%13,6918,4924.50.20%0.00%0.00%0.00%

200000ADIVERS ORTHESES35,6582,555,31923.60%713,214457,3508.61.20%0.60%0.80%0.70%

2545070PROTHESE OCULAIRE, RENOUVELLEMENT AVEC PRISE D'EMPREINTE COMPLEMENTAIRE373727,64523.30%27,64527,6451000.00%0.00%0.00%0.00%0.00%

2497884ORTHESE D'AVANCEE MANDIBULAIRE, RESMED, NARVAL ORM308308104,45122.50%104,39165,2116.10.00%0.00%0.00%0.10%0.10%

220000IVERRES UNIFOCAUX OP5 (CMU)9,546623,98020.80%99,39462,5996.80.30%0.20%0.10%0.10%

2531894PROTHESE OCULAIRE PROVISOIRE AVEC PRISE D'EMPREINTE12412454,82620.80%54,46254,4621000.00%0.00%0.00%0.10%0.10%

220000HVERRES UNIFOCAUX OP4 (CMU)3,131190,77619.90%23,06514,5066.50.10%0.00%0.00%0.00%

2575986PROTHESE FACIALE, SUR DEVIS272797,12117.40%103,616103,60196.60.00%0.00%0.00%0.10%0.20%

2185908VETEMENT COMPRESSIF, SHORT23116539,17917.20%33,01227,75357.40.00%0.00%0.00%0.00%0.00%

Total des 30 premiers produits du titre II101,800147,5149,930,6134,670,0593,637,7374.40%4.90%2.20%4.70%5.20%



TITRE III Produits implantables

3185827ENDOPROTHESE CORONAIRE, STENT LIB EVEROLIMUS,ABBOTT,XIENCE ALPINE,DIAM 3,00 MM304303251,57528651.50%259,210259,2101000.20%0.20%0.40%0.00%0.40%

3109051ENDOPROTHESE CORONAIRE, STENT LIB EVEROLIMUS,ABBOTT,XIENCE ALPINE, DIAM 2,50 MM220218179,08020366.30%186,682186,44599.50.20%0.20%0.30%0.00%0.30%

3187619ENDOPROTHESE CORONAIRE, STENT LIB EVEROLIMUS, ABBOTT,XIENCE ALPINE,DIAM 3,50 MM193193157,6668909.50%164,010164,0101000.10%0.20%0.20%0.00%0.20%

3160626ENDOPROT CORONAIRE, STENT LIB, ZOTAROLIMUS, MEDTRONIC, RESOLUTE ONYX, 3,50MM,182182155,0505806.70%155,155154,98799.50.10%0.10%0.20%0.00%0.20%

3136450ENDOPROT CORONAIRE, STENT LIB, ZOTAROLIMUS, MEDTRONIC, RESOLUTE ONYX, 2,75MM,149149127,0504740.00%127,050126,88299.30.10%0.10%0.20%0.00%0.20%

3121075ENDOPROT CORONAIRE, STENT LIB, ZOTAROLIMUS, MEDTRONIC, RESOLUTE ONYX, 3,00MM,219218187,0054174.40%187,075187,0751000.20%0.20%0.30%0.00%0.30%

3416238STIMULATEUR CARDIAQUE TRIPLE CHAMBRE, BOSTON, VISIONIST2727108,0002600.00%108,000108,0001000.00%0.00%0.20%0.00%0.20%


3133227ENDOPROTHESE CORONAIRE, STENT LIB, SIROLIMUS, TERUMO, ULTIMASTER DIAM 3,5 MM,959574,3111726.40%80,81580,8151000.10%0.10%0.10%0.00%0.10%


3402762STIMULATEUR CARDIAQUE TRIPLE CHAMBRE, MEDTRONIC, VIVA CRT-P242496,0001100.00%96,00096,0001000.00%0.00%0.10%0.00%0.10%

3134735ENDOPROTHESE CORONAIRE, STENT LIB, SIROLIMUS, CID, CRE 8, DIAM 3,00MM343228,8751000.00%28,87528,8751000.00%0.00%0.00%0.00%0.00%


340000AIMPLANT MU PAR ELECTRICITE1422,150643.50%22,15022,1501000.00%0.00%0.00%0.00%


3159304ENDOPROTHESE CORONAIRE, STENT LIB, SIROLIMUS, CID, CRE 8, DIAM 2,50MM302925,270477.60%25,27025,2701000.00%0.00%0.00%0.00%0.00%


3150711ENDOPROTHESE AORTIQUE, COOK FRANCE, ZENITH ALPHA, CORPS PRINCIPAL,222270,038450.00%70,03870,0381000.00%0.00%0.10%0.00%0.10%

3119210ENDOPROTHESE PERIPHERIQUE, STENT LIB EVEROLIMUS, ABBOTT, XIENCE PRIME BTK383731,978442.90%31,97831,9781000.00%0.00%0.00%0.00%0.00%

3477300NEUROSTIMULATEUR MEDULLAIRE, SYSTEME COMPLET + ACCESSOIRES, ST JUDE, GENESIS4422,740300.00%22,74022,7401000.00%0.00%0.00%0.00%0.00%

3413079STIMULATEUR CARDIAQUE DE RE-SYNCHRO VENTRICULAIRE, BIOTRONIK, ELUNA 8 HF-T,181884,600260.00%84,60084,6001000.00%0.00%0.10%0.00%0.10%

3163369IMPLANT D'EMBOLISATION LIQUIDE, EV3, ONYX 34 OU ONYX LES 34,452427,540221.40%27,54027,5401000.00%0.00%0.00%0.00%0.00%

3102110ENDOPROTHESE CORONAIRE LIB, SIROLIMUS, B BRAUN, COROFLEX ISAR, DIAM 3,50282823,800172.00%23,80023,8001000.00%0.00%0.00%0.00%0.00%

3494066MONITEUR ECG IMPLANTABLE, MEDTRONIC, REVEAL XT484860,045166.70%60,04555,79164.60.00%0.00%0.10%0.00%0.10%

3426550STIMULATEUR CARDIAQUE DOUBLE CHAMBRE FREQ, ASSERV,, BIOTRONIK, ELUNA 8 DR-T,262262898,947164.30%898,947896,20298.50.20%0.20%1.30%0.00%1.30%

3123387UROGENITAL, AMS, POMPE DE CONTROLE, AMS 800151550,679150.00%50,67950,6791000.00%0.00%0.10%0.00%0.10%

3444105STIMULATEUR CARDIAQUE SIMPLE CHAMBRE FREQ, ASSERV,, BIOTRONIK, ELUNA 8 SR-T,7373215,177149.60%215,177215,1771000.10%0.10%0.30%0.00%0.30%

3137159ENDOPROTHESE CORONAIRE LIB, SIROLIMUS, B BRAUN, COROFLEX ISAR, DIAM 2,75272723,170140.70%23,17023,1701000.00%0.00%0.00%0.00%0.00%

3128433ENDOPROTHESE AAA, MF SAS, ENDURANT II, CORPS AUI,121238,202140.00%38,20238,2021000.00%0.00%0.10%0.00%0.10%

3175711GENOU, EMBASE DE REPRISE, NON CIMENTEE303037,710126.70%37,71037,7101000.00%0.00%0.10%0.00%0.10%

Total des 30 premiers produits du titre III2,6542,6363,448,0193,497,6443,490,0741.70%1.80%4.90%0.00%5.00%




TITRE IV - Achats et rparations de fauteuils

4111854VHP, PROPULSION ELECTRIQUE, A DOSSIER NON INCLINABLE171753,347208.20%45,94845,9481000.10%0.10%0.50%0.60%0.60%

4300348VHP, PROPULSION MANUELLE, DISPOSITIF DE PROPULSION PAR MOTEUR ELECTRIQUE3535168,106107.90%77,64077,6401000.10%0.20%1.70%0.90%0.90%

4389845VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION DE ROUES53350141,90123.20%30,01630,0161002.10%2.20%0.40%0.40%0.40%

4348622VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, HORS ROUES ET COMPOSANTS ELECTRIQUES70066160,89720.00%49,52749,5271002.80%2.80%0.60%0.60%0.60%

4252810VHP, POUSSETTE OU FAUTEUIL NON REGLABLE, DOSSIER OU SIEGE RIGIDES OU NON2,2032,159773,32311.30%770,957770,9571008.80%9.30%7.80%9.30%9.30%

4307994VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION COMPOSANTS ELECTRIQUES571559182,0318.40%142,103142,1031002.30%2.40%1.80%1.70%1.70%

4168966VHP, PROPULSION ELECTRIQUE, VERTICALISATEUR ELECTRIQUE2323267,0923.80%119,312119,3121000.10%0.10%2.70%1.40%1.40%

4107723VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE1,8921,8921,193,4883.40%1,057,9491,057,9491007.50%8.10%12.10%12.70%12.70%

4233570VHP, CHASSIS ROULANT DESTINE A RECEVOIR LE SYSTEME DE SOUTIEN DU CORPS908908248,7750.80%239,544239,5441003.60%3.90%2.50%2.90%2.90%

4307824VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, REPARATION DE ROUES1,1091,02970,5940.60%62,96662,9661004.40%4.40%0.70%0.80%0.80%

4122757VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, VERIN PNEUMATIQUE2992991,726,525-0.80%1,173,3441,173,3441001.20%1.30%17.50%14.10%14.10%

4122473VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE, ARTICULATION MEDIANE146146100,136-4.10%88,15388,1531000.60%0.60%1.00%1.10%1.10%

4302152VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, AUTRES REPARATIONS DONT SELLERIE1,4181,355118,392-4.40%105,273105,2731005.60%5.80%1.20%1.30%1.30%

4118193VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER INCLINABLE4,5244,4972,912,834-5.40%2,709,3832,709,38310018.00%19.30%29.50%32.60%32.60%

4325302VHP, PROPULSION MANUELLE, APPUI-TETE1,6321,630108,498-6.60%103,476103,4761006.50%7.00%1.10%1.20%1.20%

4375116VHP, PROPULSION MANUELLE, PLIANT, COUSSIN DE SIEGE OU DE DOSSIER AVEC HOUSSE3,8983,517148,278-7.40%136,102136,10210015.50%15.10%1.50%1.60%1.60%

4342654VHP, PROPULSION MANUELLE, REPOSE-JAMBE DROIT OU GAUCHE, REPOSE-PIED ARTICULE3,1022,051337,052-11.40%327,892327,89210012.30%8.80%3.40%3.90%3.90%

4179540VHP, PROPULSION MANUELLE, POUR ACTIVITES PHYSIQUES ET SPORTIVES5353119,206-11.60%29,80229,8021000.20%0.20%1.20%0.40%0.40%

4130136VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, PLATINES CRANTEES160160626,980-13.30%558,072558,0721000.60%0.70%6.40%6.70%6.70%

4134364VHP, PROPULSION MANUELLE, EVOLUTIF, POUR ENFANT A PARTIR DE 18 MOIS222232,298-17.70%20,30620,3061000.10%0.10%0.30%0.20%0.20%

Total des 20 premiers produits du titre IV23,24521,5149,289,7547,847,7627,847,76292.40%92.40%93.90%94.40%94.40%

Tableau 7

Classes technico-thrapeutiques

Codes actes mdicauxLibll prestationNiveau 1Niveau 2Niveau 3TitreChapitreRecodage

3511Appareils d'assistance respiratoire, oxygnothrapie domicileRR01R0111110000A

3512Autres matriels pour traitements domicile (Titre I - chap1)ZZ01Z0111110000B

3518Appareils gnrateurs d'arosolRR02R0211110000C

3513Matriels et appareils de contention et de maintienZZ02Z0212120000A

3514Matriels et appareils pour traitement diversZZ03Z0313130000A

3516Nutriments pour intolrants au GlutenAA10A10A13130000B

3515Articles de pansementDD01D0114140000A

3521Orthses petit appareillage (Titre II - chap1)OO01O0121210000A

3531Optique mdicale proprement dit SS10S1022220000A

3532Montures (titre II - chap2)SS10Si 18 ans, S10D22220000B

3533Verres (titre II - chap2)SS10S1022220000C

3535LentillesSS20S20A22220000D

3536Verres UNIFOCAUX OP1 (CMU)SS10Si 18 ans, S10D22220000E

3537Verres UNIFOCAUX OP2 (CMU)SS10Si 18 ans, S10D22220000F

3538Verres UNIFOCAUX OP3 (CMU)SS10Si 18 ans, S10D22220000G

3539Verres UNIFOCAUX OP4 (CMU)SS10Si 18 ans, S10D22220000H

3581Verres UNIFOCAUX OP5 (CMU)SS10Si 18 ans, S10D22220000I

3582Verres UNIFOCAUX OP6 (CMU)SS10Si 18 ans, S10D22220000J

3583Montures (CMU)SS10Si 18 ans, S10D22220000K

3541Appareils lectroniques de surditSS40S4023230000A

3542Prothses externes non orthopdiquesEE01E0124240000A

3543Prothses oculaires et facialesEE30E3025250000A

3544Chaussures orthopdiquesOO40O4026260000A

3545Orthoprothses (Titre II -chap7)OO02O0227270000A

3551Implants internesYY01Y013300000A

3552Implants mus par lectricitYY02Y0234340000A

3561Vhicules pour handicaps physiquesKK01K014 400000A

3517Aliments destins des fins mdicalesAA01A0110100000A

3522Divers OrthsesOO03O0320200000A

3572Ecart TIPSWW01W0150500000A

3574PEC exeptionnelleWW02W0250500000A

m93cgaiPice jointeTB LPP 2016s.xlsx

4

LES DONNEES 2016 Les dpenses globales de la liste des produits et prestations en hausse En 2016, le montant des dpenses des patients du rgime agricole (dpenses globales, dpassements compris) lies aux produits de la LPP slve 891 millions deuros, augmentant de 2,9 % sur un an. Les titres I (Maintien domicile) et II (Orthses, appareils de soutien et prothses externes) augmentent respectivement de 3,3 % et 3,2 %. Les dpenses lies au titre III (Produits implantables) restent stables tandis que et celles lies au titre IV (Achats et rparations des fauteuils roulants), baissent cette anne encore de 2,0%. Les postes de dpenses les plus levs sont organes des sens et sphre ORL (optique et audioprothses) avec prs de 324 millions deuros, appareil respiratoire avec 108 millions deuros, et appareils orthopdiques externes pour 85 millions deuros. Ces trois postes reprsentent 59 % de la dpense totale de la LPP. Une rpartition ingale du montant remboursable Le montant remboursable global slve 571 millions deuros (+ 2,5%), et est trs fortement concentr. Quatre classes sur onze reprsentent 58% du montant total. Il sagit de lappareil respiratoire (19%), du maintien domicile (14%), de la dermatologie (12%) et de lappareillage orthopdique externe (12%).

Dcomposition du montant remboursable selon la classe technico-thrapeutique

Des remboursements au titre de la LPP en augmentation Le montant global rembours par le rgime agricole est de 494 millions deuros, en croissance de 2,4%. Cette croissance sobserve surtout pour les produits des titres I et II avec respectivement 3,0 % et 2,2 %. Les remboursements du titre III sont galement en augmentation, dans une moindre mesure, de 0,3 %, tandis que ceux qui relvent du titre IV reculent cette anne (0,9 %). Les classes appareil respiratoire (88 millions deuros de remboursements) et maintien domicile (72 millions deuros) concentrent eux seuls 33% des remboursements de la LPP. Les bnficiaires de la LPP : une consommation de soin diffrente selon lge Les classes technicothrapeutiques, qui concentrent le plus grand nombre de bnficiaires, sont : - loptique, verres et montures (567 000

bnficiaires), - les pansements (542 000 bnficiaires), - les orthses, petit appareillage (415 000

bnficiaires).

Le maintien domicile est la classe pour laquelle lge moyen des bnficiaires est le plus lev (81,7 ans). A linverse, les classes concernant les plus jeunes (ge moyen infrieur 60 ans) sont celles des Organes des sens et sphre ORL (56,9 ans) et de la Neurologie (57,7 ans).

Les 3 classes qui comptent la plus grande part de bnficiaires en ALD sont:

H - Mtabolisme (suivi des diabtiques) : 91,2 %

des bnficiaires en ALD

T - Maintien domicile (lits mdicaux et

perfusions) : 81,0 %

C - Systme cardio-vasculaire : 78,0 %.

Les chaussures thrapeutiques usage temporaire : des remboursements multiplis par 3 Au rgime agricole, les remboursements de chaussures thrapeutiques usage temporaire (CHUT, classe appareil orthopdique externe ) ont trs fortement augment entre 2012 et 2016. En 2016, la MSA remboursait 107 000 chaussures contre 31 700 en 2012, soit prs de 3 fois plus.

Nombre de CHUT rembourss de 2012 2016

Une utilisation rpte sur plusieurs semestres nest a priori pas justifie. En effet, ces articles sont destins un usage temporaire . Un travail daccompagnement des prescripteurs, dont 88 %

Source : MSA

5

sont des mdecins gnralistes) va donc tre propos par la MSA, pour un meilleur respect des conditions de prise en charge et de renouvellement de ces dispositifs mdicaux. Un reste charge toujours aussi important sur les audioprothses Le reste charge global (somme du reste charge de tous les assurs) concernant les audioprothses pour les assurs de plus de 20 ans slve 64,8 millions deuros en 2016. Le reste charge moyen pour une seule audioprothse se chiffre 1 338 . Dans 80 % des cas, les assurs MSA squipent pour les deux oreilles, portant donc le total du reste charge moyen 2 676 par assur (20 de plus quen 2015). La pression positive continue toujours en hausse La pression positive continue (PPC) pour traitement de lapne du sommeil (forfait 9), qui reprsente un tiers des remboursements de la classe appareil respiratoire (soit 30 millions deuros), crot sur la mme tendance que lanne prcdente (12 % contre 13 % en 2015). Cette augmentation est en relation direct avec le nombre dassurs rembourss au titre de la PPC, qui lui aussi augmente en 2016.

Le nombre dassurs rembourss au titre de la PPC est en hausse (13,6 %) portant le nombre 54 000. Il sagit dune population majoritairement masculine (76 % dhommes) et dont une grande partie suit un traitement sur le long terme (au moins 40 semaines de PPC pour les trois quarts dentre eux). Rpartition des assurs PPC selon leurs semaines de

traitement Nombre de semaines

de traitement Nombre d'assurs Rpartition

1 4 semaines 907 1,7%

5 13 semaines 2 598 4,8%

14 26 semaines 4 408 8,2%

27 39 semaines 4 052 7,5%

40 semaines et plus 41 916 77,8%

Une meilleure prise en charge des prothses mammaires externes Au cours de lanne 2016, 14 nouveaux types de prothses mammaires externes ( vise rparatrice) ont t introduits dans la LPP, pour rpondre un

besoin damlioration de la prise en charge adapte. Grce ces nouvelles prothses mieux rembourses, le taux de reste charge global (part de la dpense restant charge de lassur sur la dpense totale) est pass de 42% en 2015 (prs de 228 000 euros) 18% (soit plus de 110 000 euros) en 2016. Cette baisse du reste charge global de prs de 52% devrait se poursuivre en 2017, mais dans une moindre mesure, en raison de lintroduction des nouvelles prothses au cours de lanne 2016. Naturellement, cette baisse du reste charge entraine une hausse du montant rembours, passant de 320 000 en 2015 500 000 en 2016.

Quantit, dpense et reste charge des prothses mammaires externes

Quantit de

prothses

Montant dpens

()

Evolution annuelle

du montant dpens

Reste charge global

()

Evolution annuelle du reste charge

global

2016 3 115 610 151 + 13 % 110 531 - 52 %

2015 3 116 538 373 + 9 % 227 944 + 30 %

2014 3 245 494 122 175 869

*Voir page 39 pour la dfinition des diffrents indicateurs (montant rembours, montant remboursable).

4

1. La dpense globale de la liste des produits et prestations

Rpartition de la dpense totale de la LPP en 2016 (en millions deuros)

Dpense

(montant prsent au remboursement)

Remboursable (base de

remboursement)

Montant rembours

Ticket modrateur

Dpassement

I- Maintien domicile 405,1 399,7 347,5 52,3 5,4

II- Orthses, appareils de soutien et prothses externes 405,6 92,6 68,1 24,4 212,4

III- Produits implantables (en sus des soins en tablissements) 70,0 70,2 70,2 0,1 0,0

IV- Achats et rparations des fauteuils roulants 9,9 8,3 8,3 0,0 1,6

TOTAL 890,6 570,8 494,1 76,8 219,4

Source : MSA

Source : MSA

Le montant des dpenses des patients du rgime agricole, lies aux produits de la LPP slve 890,6 millions deuros. Les titres I (Maintien domicile) et II (Orthses, appareils de soutien et prothses externes) concentrent la plus grosse part de ses dpenses, avec 405 millions deuros chacun.

5

2. Vue Assurance Maladie

Rpartition de la base de remboursement de la LPP en 2016 (en millions deuros)

TITRES Quantit dactes Base de

remboursement (remboursable)

Montant rembours

Ticket modrateur

Taux de produits pris en charge

100%

I- Maintien domicile 8 045 253 399,7 347,5 52,3 56,2%

II- Orthses et prothses externes 2 963 895 92,6 68,1 24,4 11,2%

III- Produits implantables (en sus des soins en tablissements)

126 465 70,2 70,2 0,1 99,9%

IV- Achats et rparations des fauteuils roulants 23 259 8,3 8,3 0,0 99,9%

TOTAL 11 158 872 570,8 494,0 76,8

Source : MSA

*base de remboursement = montant rembours + ticket modrateur

Le montant remboursable global slve 570,5 millions deuros et se rpartit de faon peu homogne. Le titre I reprsentent 70% du montant

remboursable.

Source : MSA

6

Evolution 2015 - 2016

TITRE Quantit dactes

Base de remboursement (remboursable)

Montant rembours

Ticket modrateur

I- Maintien domicile +2,4% +3,0% +3,0% +3,4%

II- Orthses, appareil de soutien et prothses externes +1,5% +2,2% +2,2% +2,1%

III- Produits implantables (en sus des soins en tablissements) -0,4% +0,2% +0,3% -23,1%

IV- Achats et rparations des fauteuils roulants -2,2% -1,0% -0,9% +0,0%

TOTAL +2,1% +2,5% +2,4% +3,0%

Source : MSA Le montant remboursable global augmente de 2,5% en 2016 soit 0,4 point de moins que lanne prcdente, avec une volution positive pour chaque

titre, except le titre IV.

Source : MSA

Source : MSA

7

Vue Assur

Rpartition de la dpense LPP en 2016 (en millions deuros)

TITRES Quantit dactes Montant

prsent au remboursement

Montant rembours

Reste charge Taux de reste

charge

I- Maintien domicile 8 045 253 405,1 347,5 57,6 14,2%

II- Orthses, appareils de soutien et prothses externes 2 963 895 405,6 68,1 337,5 83,2%

III- Produits implantables (en sus des soins en tablissements) 126 465 70,0 70,2 - 0,0%

IV- Achats et rparations des fauteuils roulants 23 259 9,9 8,3 1,6 16,2%

TOTAL 11 158 872 890,6 494,1 396,5 44,5%

Source : MSA

Selon le titre, le reste charge global des assurs ne se rpartit pas de la mme manire. Il reprsente plus de 83% de leur dpense pour le titre II,

tandis quil nest que de 14% et 16% pour les titres I et III.

Source : MSA

8

Evolution 2015 - 2016

TITRE Quantit dactes

Montant prsent au

remboursement

Montant rembours

Reste charge

I- Maintien domicile +2,4% +3,3% +

Documents

Tableau de bord - statistiques.msa.fr · Décembre 2017 Tableau de bord LPP La liste des produits et prestations (LPP) remboursés par le régime agricole en 2016 DIRECTION DELEGUEE