Tableau de bord - statistiques.msa.fr · Tableau de bord LPP La liste des produits et prestations remboursés par le régime agricole en 2015 DIRECTION DES ETUDES, DES REPERTOIRES

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Tableau de bord Liste des Produits et Prestations

remboursables en 2015 octobre 2016

Tableau de bord LPP

La liste des produits et prestations rembourss par le rgime agricole en 2015

DIRECTION DES ETUDES, DES REPERTOIRES ET DES STATISTIQUES Directeur de la publication : Alain PELC [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 Mireille MEDELICE [email protected] Nadia FERKAL [email protected]

DIRECTION DELEGUEE AUX POLITIQUES SOCIALES Collge mdical : Dr Sandrine FARE [email protected]

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

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SOMMAIRE

LES DONNEES 2015 ...................................................................................................................................................................................................................................................... 4

1. LA DEPENSE GLOBALE DE LA LPP ......................................................................................................................................................................................................................... 6 2. VUE ASSURANCE MALADIE ............................................................................................................................................................................................................................. 7 3. VUE ASSURE .................................................................................................................................................................................................................................................. 9

ANNEXES ...................................................................................................................................................................................................................................................................... 11

GRAPHIQUES 1 A 11 - LES REPARTITIONS DES POSTES DE REMBOURSEMENT DE LA LPP EN 2015 ................................................................................................................................... 12 GRAPHIQUE 12 LES 10 CLASSES PRESENTANT LES PLUS FORTS RESTE A CHARGE DE LA LPP EN 2015 ......................................................................................................................... 16 TABLEAU 1 - LES GRANDES CLASSES TECHNICO-THERAPEUTIQUES EN 2015, PAR MONTANT REMBOURSABLE - NIVEAU 1 ................................................................................................... 16 TABLEAU 2 - LES CLASSES TECHNICO-THERAPEUTIQUES EN 2015 NIVEAU 2 (TABLEAU 1 DETAILLE PAR CLASSE TECHNICO-THERAPEUTIQUE) .................................................................. 18 TABLEAU 3 - LES CLASSES TECHNICO-THERAPEUTIQUES EN 2015 - NIVEAU 3 .................................................................................................................................................................. 20 TABLEAU 4 - TOP 30 PAR QUANTITE D'ACTES EN 2015 .................................................................................................................................................................................................. 26 TABLEAU 5 - TOP 30 PAR MONTANT DE LA BASE DE REMBOURSEMENT (MONTANT REMBOURSABLE) EN 2015 ................................................................................................................... 30 TABLEAU 6 - TOP 30 PAR EVOLUTION DES MONTANTS PRESENTES AU REMBOURSEMENT ENTRE 2014 ET 2015 (POUR LES MONTANT > 20.000).............................................................. 34

DEFINITIONS ET METHODE ....................................................................................................................................................................................................................................... 38

1. DEFINITIONS ET INDICATEURS .............................................................................................................................................................................................................................. 38 2. CODAGE DE LA LPP............................................................................................................................................................................................................................................ 40 TABLEAU 7- TABLEAU DE RECODAGE ............................................................................................................................................................................................................................ 41

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LES DONNEES 2015 Les dpenses globales de la LPP se stabilise En 2015, le montant des dpenses des patients du rgime agricole (dpenses globales, dpassements compris), lies aux produits de la LPP slve 841 millions deuros, augmentant de + 0,3 % par rapport lanne prcdente. Les titres I (Maintien domicile) et III (Produits implantables) augmentent respectivement de + 2,8 % et + 1,4 %. Les dpenses lies au titre II (Orthses, appareils de soutien et prothses externes) et IV (Achats et rparations des fauteuils roulants), baissent respectivement, de -2,6% et - 3,8% en 2015. Les postes de dpenses les plus levs sont organes des sens et sphre ORL (optique et audioprothses) avec prs de 293 millions deuros, appareil respiratoire avec 104 millions deuros, et appareils orthopdiques externes pour 81 millions deuros. Ces trois postes reprsentent 57 % de la dpense totale de la LPP. Rpartition du montant remboursable

Tout comme la dpense, le montant remboursable global qui slve 556 millions deuros, est rparti de faon peu homogne.

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%). Les remboursements au titre de la LPP augmentent Le montant global rembours par le rgime agricole est de 482 millions deuros, en croissance de + 2,8%. Cette croissance sobserve surtout pour les produits des titres I et II avec respectivement + 2,9 % et + 4,4 %. Les remboursements affrents au titre III sont galement en augmentation avec + 1,3 %, tandis que ceux qui relvent du titre IV reculent (- 3,4 %) Les classes appareil respiratoire (86 millions deuros de remboursements), et maintien domicile (71 millions deuros) concentrent eux seuls 31% des remboursements de la LPP. Les remboursements lis au systme cardio-vasculaire en hausse La classe systme cardio-vasculaire est celle dont le montant total des remboursements enregistre la plus importante volution en 2015 : + 9,7% contre - 0,3% en 2014. Cette hausse est principalement due aux valves cardiaques transcutanes (TAVI), admises au remboursement depuis 2012, qui augmentent de 800 % en 2015 par rapport 2014, atteignant 3,6 M en 2015 (contre 420 000 en 2014). Cette augmentation est imputable l'extension des indications de pose de ces dispositifs, valides par la Haute Autorit de sant en octobre 2014 et admises au remboursement par arrt publi au journal officiel du 17 dcembre 2015. Compte tenu de ces indications supplmentaires, la population cible annuelle a t value la hausse et concerne dsormais 10 250 patients tous rgimes confondus (soit un doublement par rapport la population cible annuelle depuis 2012 : 5 175 patients). Afin de contenir le montant des remboursements de ces

dispositifs, leur tarif de remboursement a t revu la baisse au 1er janvier 2016, et une baisse supplmentaire sera galement applique au 1er janvier 2017. Les bnficiaires de la LPP Les classes technicothrapeutiques qui concentrent le plus grand nombre de bnficiaires sont : - loptique, verres et montures (562 000

bnficiaires) - les pansements (541 000 bnficiaires) - les orthses, petit appareillage ( 409 000

bnficiaires).

Le maintien domicile est la classe pour laquelle lge moyen des bnficiaires est le plus lev (81,2 ans). Les classes concernant les plus jeunes (ge moyen infrieur 60 ans) sont celles des Organes des sens et sphre ORL (57,0 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) : 90,6 %

des bnficiaires en ALD

T - Maintien domicile (lits mdicaux et

perfusion) : 79,1 % en ALD

C - Systme cardio-vasculaire (lits mdicaux et

perfusion) : 77,7 % en ALD

Les audioprothses : un poste de dpenses important, en hausse constante depuis 2013 Les audioprothses sont un poste de dpenses important des assurs : 67 millions deuros en 2015 (soit prs de 8% de la dpense totale des assurs), dont 10 millions deuros sont rembourss. Il existe pour les adultes et les enfants quatre types daudioprothses (A, B, C et D) rembourss. Nanmoins, les audioprothses de classe D concentrent 95 % des volumes et des

Source : MSA

5

remboursements daudioprothses, soit 45 000 audioprothses pour 5,7M rembourss. Cette surreprsentation tend dailleurs saccentuer au vu de lvolution annuelle des volumes daudioprothses.

Audioprothses de type D

Quantit de produit

Evolution quantit de

produit Montant

rembours

Evolution du montant rembours

2015 44 980 9% 5 729 893 9%

2014 41 305 9% 5 246 512 9%

2013 37 887 3% 4 821 430 3%

2012 36 839 -1% 4 698 585 -5%

Une croissance soutenue des siges coquille Le sige coquille est un dispositif mdical de confort destin une population griatrique sans autonomie, confine au lit ou au fauteuil. La MSA sintresse aux siges coquilles tant donn lobservation dune forte augmentation des dpenses ces dernires annes, sur un dispositif sens tre prescrit une population relativement rduite. En 2015, 12 439 siges coquilles ont t rembourss par le rgime agricole, soit plus de 3 600 000 . Le sige coquille de srie, amovible, modle avec cales et maintien auto accrochables (Code LPP : 1283365) concentre la quasi-totalit des volumes et des remboursements (97 %).

Tlcharger les donnes au format Excel :

En 2015, la quantit de siges coquille 1283365 prsent au remboursement a augment de + 4 %. Une augmentation moins importante que les annes prcdentes (+ 8 % en 2014 et + 13 % en 2013) mais toujours positive. Il est noter quentre 2010 et 2015 le volume de ces siges prsent au remboursement a augment de 75%. La PPC repart la hausse La pression positive continue pour traitement de lapne du sommeil (forfait 9), qui reprsente prs de 32 % des remboursements au titre de lappareil respiratoire (27 millions deuros), poursuit sa tendance haussire. Cette volution atteint + 13 % cette anne (contre + 6 % en 2014).

Le nombre dassurs concerns par ce dispositif reste galement en hausse, mais sur une tendance moins forte que lanne prcdente avec + 9,8 % contre + 17 % en 2014. Suite linscription de nouvelles indications thrapeutiques, une baisse est attendue en 2016 en termes de volumes et de remboursements, au profit des orthses davance mandibulaire, qui sont une alternative mcanique moins coteuse que le dispositif de traitement par PPC.

Donnees 2015



Quantit de produitEvolution quantit de produitMontant remboursEvolution du montant rembours

201544,9809%5,729,8939%

201441,3059%5,246,5129%

201337,8873%4,821,4303%

201236,839-1%4,698,585-5%

Depense globale

TitreDpense(montant prsent au remboursement)Remboursable(base de remboursement)Montant remboursTicket modrateurMontant du dpassement

1- Maintien domicile392.3388.0337.550.54.3

2- Orthses, appareil de soutien et prothses externes368.490.166.623.9278.3

3- Produits implantables (en sus des soins en tablissements)70.070.069.90.10.0

4- Achats et rparations des fauteils roulants10.18.38.30.01.8

Total840.8556.4482.374.5284.4

Vue assurance maladie

TitreQuantit d'actesBase de rembourse-mentMontant remboursTicket modrateurPart de prise en charge 100% (en %)

I- Maintien domicile7855862388.0337.550.556.5

II- Orthses, appareils de soutien et prothses externes291990590.166.723.911.5

III- Produits implantables (en sus des soins en tablissements)12697370.069.90.199.5

IV- Achats et rparations des fauteuils roulants237938.48.40.099.9

TOTAL10,926,53355748375

Evolution 2014-2015

titreQuantitd'actesBase de rembourse-mentMontant remboursTicket modrateur

1- Maintien domicile-6.1%3.2%2.9%5.0%

2- Orthses, appareil de soutien et prothses externes2.2%3.4%4.4%3.5%

3- Produits implantables (en sus des soins en tablissements)-0.5%1.4%1.3%0.0%

4- Achats et rparations des fauteils roulants-4.6%-3.4%-3.4%0.0%

-3.9%2.9%2.8%4.5%

vue assurs

TitresQuantit d'actesMontant prsent au rembour-sementMontant remboursTaux de reste charge

1- Maintien domicile7,855,862392.30337.5014.2%

2- Orthses, appareil de soutien et prothses externes2,919,905368.4066.6081.9%

3- Produits implantables (en sus des soins en tablissements)126,97370.0069.900.1%

4- Achats et rparations des fauteuils roulants23,79310.108.3015.8%

10,926,53384148242.7%

Evolution 2014-2015



2- Orthses, appareil de soutien et prothses externes2.2%3.4%4.4%3.5%

3- Produits implantables (en sus des soins en tablissements)-0.5%1.4%1.3%0.0%

4- Achats et rparations des fauteils roulants-4.6%-3.4%-3.4%0.0%

-3.9%2.9%2.8%4.5%

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 2014Montant remboursableMontant remboursEvolution 2014Taux de rembour-sement.TMReste charge

moyenen ALDmdicaux20152015

(en %)

R- Appareil respiratoire153,95863.256.254.6650,6013,042,7461,019,578104,326,8201.90%104,183,82585,715,4030.50%82.318,468,42218,611,417

T- Maintien domicile110,61781.14179.1905,3604,436,1171,078,83877,066,4645.50%77,320,93570,973,6505.50%91.86,347,2856,092,814

D- Dermatologie555,70260.150.839.41,338,9265,289,3682,417,04167,652,0361.70%65,898,42552,906,6053.00%80.312,991,82014,745,430

O- Appareil orthopdique externe633,25661.141.535.6451,556462,6721,144,45181,985,6732.40%65,056,81550,090,2184.30%7714,966,59831,895,455

H- Mtabolisme106,99169.952.490.61,046,0192,937,7761,113,22543,661,9013.60%43,749,00742,607,8303.90%97.41,141,1781,054,071

M- Implants orthopdiques22,9416751.433.839,074113,101107,19342,168,903-2.50%42,173,61442,163,771-2.50%1009,8435,132

A- Appareil digestif et abdomen117,13566.441.661.5902,4323,410,2771,196,27641,704,2975.00%41,278,97236,933,7624.40%89.54,345,2104,770,535

K- Aide la vie et fauteuils roulants (VPH)139,15973.44161.6442,7111,697,111576,54841,841,9240.30%39,063,23335,692,0770.50%91.43,371,1566,149,846

S- Organes des sens et sphre ORL674,054574726.5541,8272,101,1162,034,172293,928,198-3.60%31,865,96020,489,2395.20%64.311,376,721273,438,959

C- Systme cardio-vasculaire8,37677.666.577.713,44817,76717,47525,869,4659.60%25,901,89225,859,3949.70%99.842,49810,071

G- Appareil gnito-urinaire38,75860.440.347.6144,439358,245185,88218,755,6734.00%18,638,75517,263,4983.60%92.61,375,2561,492,175

E- Prothses rparatrices vise esthtique6,47267.516.572.75,3897,5937,4912,164,282-6.10%1,318,8731,262,998-2.60%95.855,875901,283

N- Neurologie6,07357.742.541.412,73354,05030,014945,222-1.30%876,467740,587-6.70%84.5135,880204,634

W - Ecart TIPS et Prise en charge Exceptionnelle1,89669.750.341.41,324-13,44980,0169.40%79,99779,9949.40%100322

Y- implants divers17967.654.746.9224-149-52-22,789-160.00%-22,789-20,928-133.60%91.8-1,861-1,861

Z- matriels divers7,28676.941.675.513,017-9,505-1,603-370,278-172.00%-246,302-159,985-131.60%65-86,317-210,293

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 2014Montant rembour-Montant remboursEvolution 2014Taux de rembour-Ticket modra-Reste charge

ciaires moyenciairesmdicauxsement2015sable2015sementteur

en ALD

(en %)

R20Pression positive continue pour apne du sommeil47,46866.876.355.2293,7952,195,606542,45739,811,2177.50%39,836,11127,452,3836.80%6912,383,72812,358,834

R10Oxygnothrapie, prestation seule20,52884.744.789115,195473,491127,71631,383,0163.30%31,390,90529,163,8541.70%932,227,0512,219,161

R30Traitements respiratoires, autres prestations9,38574.462.786.885,363356,44898,40228,615,034-6.60%28,628,05425,648,126-7.40%902,979,9282,966,909

R02*appareils gnrateurs d'arosol70,07765.146.953.8146,806228,8074,350,2056.70%4,320,1893,506,4526.20%81813,736843,753

R50Respiratoire : chambres dinhalation, implants et autres21,76730.350.425.25,76323,28123,106515,6444.60%334,043212,8177.60%64121,226302,827

R01*appareils d'assistance respiratoire, oxygnothrapie domicile2,3467366.271.23,679-6,080-910-348,29618.30%-325,477-268,2294.30%82-57,248

T30Lits mdicaux79,63984.239.582.7582,7412,768,131711,46446,571,7374.20%46,552,87042,211,7743.80%914,341,0964,359,963

T40Matriel anti-escarres, matelas et coussins53,55183.141.780124,137367,069147,02814,166,8514.80%14,110,77812,752,5414.90%901,358,2371,414,310

T10Perfusions, systmes passifs28,95674.745.474.2160,5911,018,225181,2328,649,88511.30%8,947,8168,464,15715.10%95483,659185,728

T20Perfusions, systmes actifs, pompes implantes ou non2,51767.46094.437,891282,69239,1147,677,9919.00%7,709,4727,545,1796.30%98164,293132,812

D10Pansements540,79860.250.939.51,300,0485,017,5452,345,52661,965,9861.00%60,940,70448,834,7112.10%8012,105,99313,131,275

D20Dispositifs de contention, bandes45,52767.142.646.637,105272,74470,0265,635,28911.70%4,906,7154,024,81017.50%82881,9051,610,479

D01*articles de pansement2,12063.350.948.31,730-9711,44136,010-70.30%36,25632,925-66.20%913,3313,086

D30Implants d'expansion ou de comblement2554.1929643504814,750-7.20%14,75014,160-10.20%96590590

O01*orthses petit appareillage409,34866.937.441.2317,195-9721,82536,795,666-1.70%28,578,67819,995,032-0.60%708,583,64516,800,634

O02*orthoprothses6,58853.254.35615,708024,05612,475,6099.10%12,447,98112,447,8559.20%10012627,754

O20Orthses de srie232,30952.74427.684,523382,353300,03818,418,6603.60%11,804,5028,050,73112.50%683,753,77210,367,930

O40Podo-orthses (Chaussures orthopdiques)7,63869.148.770.810,62515,04814,6976,626,769-1.20%6,647,4155,816,005-2.90%87831,409810,764

O50Dispositifs injectables viscolastiques31,0117044.435.412,08843,07034,1844,655,1822.80%4,270,4202,760,3442.30%651,510,0761,894,839

O03*Divers Orthses16,94446.147.217.24,944-42728,3342,040,44133.90%514,151326,19930.50%63187,9511,714,242

O30Orthoprothses sur mesure 21960.486.366.7195290285491,453106.20%491,453491,453106.20%10000

O10Dispositifs de maintien, protection et immobilisation19,40055.449.329.96,27822,34721,032481,8913.50%302,216202,5986.80%6799,618279,293

H10Dispositifs pour autocontrle du diabte100,08870.352.392.1680,857889,567729,91327,415,5572.70%27,482,46726,671,3223.10%97811,146744,235

H20Dispositifs pour auto traitement du diabte (pompes, seringues, aiguilles)58,25370.651.294.5361,6762,036,083377,22716,103,2415.10%16,123,73415,821,0895.00%98302,646282,152

H30Dispositifs pour auto traitement et autocontrle autres que pour diabte2,38561.976.154.83,48612,1266,085143,10215.80%142,806115,41916.80%8127,38727,683

M20Implants orthopdiques du genou6,49171.946.838.79,91824,97524,84917,070,689-4.40%17,072,73417,070,928-4.30%1001,805-240

M30Implants orthopdiques de la hanche8,70675.348.142.915,34335,91135,89316,032,894-4.90%16,032,85416,027,565-4.90%1005,2895,329

M60Implants orthopdiques autres, dont cheville, crne14,91465.45132.19,30636,72033,2583,828,2926.90%3,830,0283,829,3797.10%100649-1,087

M10Implants orthopdiques (coude, paule, poignet, main et doigt)1,27472.428.136.61,6044,1294,1092,235,4869.90%2,233,5932,232,7469.80%1008482,741

M40Implants orthopdiques du rachis1,28458.853.926.62,0498,9096,6681,721,1891.90%1,723,0961,722,9492.00%100146-1,761

M50Greffons, substituts et implants osseux1,9076555.133.68542,4572,4161,280,3532.80%1,281,3091,280,2032.90%1001,106150

A10Nutrition orale107,14765.73959.4781,4602,718,3441,059,62926,092,0917.10%25,642,83721,919,3006.70%853,723,5374,172,792

A30Dispositifs pour stomies digestives12,41677.570.484.986,818171,25196,0148,866,5132.20%8,863,1398,387,0482.20%95476,091479,465

A20Nutrition entrale, poches et prestations1,96860.467.893.633,467520,66534,9586,225,3643.90%6,252,6746,107,2533.10%98145,421118,110

A01*Aliments destins des fins mdicales9325.154.894.66855,658503,329-22.10%503,322503,161-22.20%100161168

A40Implants, anneaux gastriques, plaques de rfection de paroi et stentssssssssssssssss

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 2014Montant rembour-Montant remboursEvolution 2014Taux de rembour-Ticket modra-Reste charge

moyenciairesmdicauxsement2015sable2015sementteur

en ALD

(en %)

K10Dispositifs daide la vie dont bquilles, dambulateurs119,5207341.459.2261,974917,741352,83720,576,0681.50%19,419,58717,264,0952.50%892,155,4923,311,973

K20Fauteuils roulants, location et achat37,82077.34176.1177,911776,271220,62520,242,825-1.00%18,640,71017,426,038-2.00%931,214,6722,816,787

K30Autres vhicules pour personnes handicapes (poussettes, tricycles)3,01381.738.683.52,6453,1743,1621,137,21214.00%1,045,2151,043,95212.30%1001,26393,260

K01*vhicules pour handicaps physiques15376.551.672.5181-75-76-114,180-7325.20%-42,279-42,007105.10%99-272-72,173

S40Audioprothses88,6807950.749.270,150179,928142,74567,440,520-1.20%15,589,27110,079,0678.10%655,510,20457,361,453

S10Optique, verres et montures562,89553.447.322.4368,9051,631,9521,667,462221,398,813-4.60%12,576,9757,742,597-0.10%624,834,378213656 215

S30Ophtalmologie, implants65,74170.7354293,353242,216203,5823,305,17620.50%2,495,9141,635,22818.90%66860,6861,669,948

S50Sphre ORL2,37768.257.674.27,83434,3798,904912,144-0.40%881,563834,6292.20%9546,93477,515

S20Optique, lentilles et aides visuelles5,93835.943.514.11,58512,64111,479871,545-3.90%322,237197,718-0.80%61124,519673,827

C40Stimulateurs cardiaques, botiers2,75483.260.176.62,1202,7662,7668,306,9662.00%8,307,0918,279,9532.10%10027,13827,013

C10Implants vasculaires52077.257.976.96159649006,314,50641.50%6,314,5066,310,60241.70%1003,9043,904

C20Stents vasculaires2,65975.467.383.23,9524,8634,7464,701,3076.60%4,709,9274,708,5666.80%1001,361-7,259

C30Stents coronariens2,78874.773.573.63,6875,0335,0013,997,337-1.70%4,019,1704,017,488-1.20%1001,682-20,151

C60Sondes dfibrillation et stimulation et autres2,25081.562.875.22,9273,9803,9042,410,208-0.10%2,410,2622,402,282-0.30%1007,9807,926

C50Dfibrillateurs implantables, botiers13471.179.192.5125135135125,38824.80%125,388125,19424.60%100194194

C70Dispositif d'assistance circulatoire mcanique (DACM)sssssssssssssss

G30Gnito-urinaire, matriel pour incontinence et sondage vsical19,73777.872.880140,584331,651163,46016,302,6723.90%16,216,75715,183,6003.70%941,033,1571,119,073

G20Gnito-urinaire, implants, dont grains d'iode, lectrostimulation10,41049.915.324.33,36516,41812,2501,913,6525.70%1,883,9431,655,8673.70%88228,076257,785

G10Dispositifs contraceptifs9,80634.90.14.849010,17610,172539,349-0.50%538,055424,031-0.10%79114,023115,318

E30Prothses oculaires et faciales1,48066.265.344.59312,0112,021626,995-2.00%630,929630,919-1.20%10010-3,924

E10Prothses mammaires3,01969.20.4792,5323,3213,211603,0058.10%402,149374,287-1.90%9327,863228,719

E20Postiches2,13065.33.985.21,9042,2752,271933,118-15.70%284,381256,018-7.30%9028,362677,100

E01*Prothses externes non orthopdiques2565.3246822-14-121,163-590.90%1,4151,775580.90%126-360-612

N10Traitement externe de la douleur6,05057.742.441.412,71753,99729,962623,67514.50%554,920423,21110.60%76131,710200,464

N20Neurostimulateurs implants3156.951.629165352321,546-22.00%321,546317,376-22.90%994,1704,170

W01*Ecart TIPS1,88169.750.441.31,3053,43880,65812.90%80,65880,65512.90%10033

W02*Prise en charge Exceptionnelle1575.94053.31911-641-137.10%-661-661-138.20%100019

Y01*implants internes17167.254.445212-45-9,988-142.80%-9,988-8,927-118.80%89-1,061-1,061

Y02*implants mus par lectricit877.462.587.512-7-12,801-187.20%-12,801-12,001-181.60%94-800-800

Z01*Autres matriels pour traitement domicile2,24272.847.880.22,8801,048-10,926-106.90%101,487127,516-25.10%126-26,030-138,443

Z03*Matriels et appareils pour traitements divers25765.24244.7135552,667-79.40%2,8322,453-71.50%87379214

Z02*Matriels et appareils de contention et de maintien 5,06679.439.175.210,002-2,706-362,019-205.80%-350,621-289,955-188.40%83-60,666-72,064

Tableau 3

Appareil respiratoire

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 2014Montant rembour-Montant remboursEvolution 2014Taux de rembourTicket modrateurReste charge

ficiaires en ALD2015sable2015sement

(en %)

R20APression positive continue pour apne du sommeil, prestation seule (forfait 9)47,23966.976.455.4293,7262,195,310542,16139,712,2347.50%39,737,94027,391,2696.80%68.912,346,67112,320,965

R30BTraitements respiratoires, prestations avec oxygne5,62476.8588947,369190,64753,29418,455,399-9.60%18,460,31417,040,439-10.30%92.31,419,8761,414,960

R10BOxygnothrapie seule, long terme liquide (forfait 2)3,70980.457.993.532,140127,96434,43513,925,109-11.50%13,941,93713,132,159-13.00%94.2809,778792,950

R10AOxygnothrapie seule, long terme gazeux8,02183.645.890.958,473254,41364,90113,359,25827.50%13,348,30112,255,78426.20%91.81,092,5171,103,473

R30ATraitements respiratoires, autres prestations seules (ventilation)4,08371.168.284.337,994165,80145,10810,159,636-0.80%10,167,7398,607,687-1.00%84.71,560,0521,551,949

R02*Appareils gnrateurs d'arosol70,07765.146.953.8146,806228,8074,350,2056.70%4,320,1893,506,4526.20%81.2813,736843,753

R10COxygnothrapie seule, court terme, seule (forfait 3)10,7998739.285.624,58291,11428,3804,098,649-1.90%4,100,6683,775,911-2.20%92.1324,756322,738

R50Respiratoire : chambres dinhalation, implants et autres21,76730.350.425.25,76323,28123,106515,6444.60%334,043212,8177.60%63.7121,226302,827

R20BOrthses d'avance mandibulaire29355.873.423.56929629698,983-3.50%98,17161,114-4.40%62.337,05737,869

R01*Appareils d'assistance respiratoire, oxygnothrapie domicile2,3467366.271.23,679-6,080-910-348,29618.30%-325,477-268,2294.30%82.4-57,248-80,067

Maintien domicile



(en %)

T30ALits mdicaux, location78,00184.339.483557,9122,734,524678,43939,195,1314.20%39,317,62735,851,9023.70%91.23,465,7253,343,228

T40AMatelas, compresseurs et accessoires.39,88183.642.180.4103,126339,351120,94212,202,1215.70%12,176,96411,021,3785.70%90.51,155,5861,180,743

T10APerfusion, diffuseurs portables et divers28,95674.745.474.2160,5911,018,225181,2328,649,88511.30%8,947,8168,464,15715.10%94.6483,659185,728

T30CLits mdicaux, accessoires et rparations29,99882.544.475.624,60733,33332,7516,950,9303.90%6,953,1036,099,3293.90%87.7853,774851,601

T20BPerfusion, pompes externes, sauf insuline, consommables2,45167.459.994.520,867124,76621,6095,548,0862.50%5,565,3765,443,9232.50%97.8121,453104,163

T20APerfusion, pompes externes, sauf insuline2,41067.260.194.717,016157,91817,4972,108,85832.80%2,123,0492,080,20919.30%9842,84028,649

T40BCoussins anti-escarres23,603834280.321,01127,71826,0861,964,730-0.20%1,933,8141,731,1630.20%89.5202,651233,567

T30BLits mdicaux, achat27078.24780.7222274274425,6768.50%282,140260,5425.40%92.321,598165,134

T20CPerfusion, systmes passifs456.82510088821,048-46.50%21,04821,048-46.50%100

Dermatologie



(en %)

D10APansements primaires ou actifs253,65766.348.747.8457,9991,050,500734,23545,744,7182.30%45,552,92936,807,9342.80%80.88,744,9948,936,783

D10BPansements secondaires ou passifs426,46259.852.439.7477,2771,303,503921,0889,027,896-4.50%8,613,2466,769,272-3.20%78.61,843,9742,258,624

D20ABandes lastiques de contention45,26367.342.646.636,298270,48368,7445,500,68911.30%4,777,5343,914,18717.40%81.9863,3471,586,501

D10CPansements, dispositifs de fixation et de maintien249,58062.751.641.5297,6942,322,057561,1323,979,779-5.20%3,560,9992,787,244-0.50%78.3773,7551,192,535

D10DSets de pansements70,43163.256.343.567,078341,485129,0713,213,5939.10%3,213,5302,470,26110.30%76.9743,270743,332

D20BVtements compressifs sur mesure29141.749.5548072,2611,282134,60027.70%129,181110,62224.60%85.618,55823,978

D01*articles de pansements2,12063.350.948.31,730-9711,44136,010-70.30%36,25632,925-66.20%90.83,3313,086

D30Implants d'expansion ou de comblement2554.1929643504814,750-7.20%14,75014,160-10.20%96590590

Appareil orthopdique externe



(en %)

O01*orthses petit appareillage409,34866.937.441.2317,195-9721,82536,795,666-1.70%28,578,67819,995,032-0.60%708,583,64516,800,634

O02*orthoprothses6,58853.254.35615,708024,05612,475,6099.10%12,447,98112,447,8559.20%10012627,754

O40Podo orthses7,63869.148.770.810,62515,04814,6976,626,769-1.20%6,647,4155,816,005-2.90%87.5831,409810,764

O20AAttelles (correction orthopdique)108,02846.148.319.924,602124,474122,3917,111,8219.70%6,610,4214,359,8268.20%662,250,5962,751,995

O50Dispositifs injectables viscolastiques31,0117044.435.412,08843,07034,1844,655,1822.80%4,270,4202,760,3442.30%64.61,510,0761,894,839

O20CColliers cervicaux + CHST63,91969.232.450.240,251111,04776,2583,619,05329.90%2,917,3802,257,51434.90%77.4659,8661,361,540

O20BSemelles71,34248.546.119.619,556146,538101,1837,664,216-9.70%2,261,9011,421,478-1.40%62.8840,4236,242,738

O03*Divers Orthses16,94446.147.217.24,944-42728,3342,040,44133.90%514,151326,19930.50%63.4187,9511,714,242

O30APied restitution d'nergie21760.586.266.8191278275366,46654.10%366,466366,46654.00%100

O10Dispositifs de maintien, protection et immobilisation19,40055.449.329.96,27822,34721,032481,8913.50%302,216202,5986.80%6799,618279,293

O30COrthoprothses mues par nergie lectrique sssssssssssss

O20DDiverses orthses (coque+therabite+montage appareil marche)15932.259.750.911429420623,57023.70%14,80011,91329.90%80.52,88711,657

O30BRotateur44310000441,971300.00%1,9711,971300.00%100

Mtabolisme



(en %)

H10BAutocontrle du diabte, consommables99,72770.452.392.1648,564851,829692,29325,405,4851.90%25,404,75824,739,0302.20%97.4665,728666,455

H20AAuto traitement du diabte, pompes externes1,93644.755.298.351,2891,063,22052,5955,670,1138.20%5,684,5755,592,4548.00%98.492,12177,659

H20CAuto traitement du diabte, matriel d'injection pour pompes1,92344.655.198.330,860639,69931,6165,282,3867.30%5,288,8045,202,9776.90%98.485,82779,409

H20DMatriel d'injection (seringues, stylos, aiguilles)56,92471.251.194.4279,527333,164293,0165,150,742-0.20%5,150,3555,025,6570.10%97.6124,698125,085

H10AAutocontrle du diabte, matriel, dont lecteurs de glycmie33,34868.352.48632,29337,73837,6202,010,07213.80%2,077,7091,932,29117.40%93145,41877,781

H30Dispositifs pour auto traitement et autocontrle autres que pour diabte2,38561.976.154.83,48612,1266,085143,10215.80%142,806115,41916.80%80.827,38727,683

Implants orthopdiques



(en %)

M20Implants orthopdiques du genou6,49171.946.838.79,91824,97524,84917,070,689-4.40%17,072,73417,070,928-4.30%1001,805-240

M30Implants orthopdiques de la hanche8,70675.348.142.915,34335,91135,89316,032,894-4.90%16,032,85416,027,565-4.90%1005,2895,329

M60Implants orthopdiques autres, dont cheville, crne14,91465.45132.19,30636,72033,2583,828,2926.90%3,830,0283,829,3797.10%100649-1,087

M10Implants orthopdiques (coude, paule, poignet, main et doigt)1,27472.428.136.61,6044,1294,1092,235,4869.90%2,233,5932,232,7469.80%1008482,741

M40Implants orthopdiques du rachis1,28458.853.926.62,0498,9096,6681,721,1891.90%1,723,0961,722,9492.00%100146-1,761

M50Greffons, substituts et implants osseux1,9076555.133.68542,4572,4161,280,3532.80%1,281,3091,280,2032.90%99.91,106150

Appareil digestif et abdomen



(en %)

A10BNutriments pour supplmentation orale96,61168.542.264767,5912,557,3371,004,53024,237,5007.20%24,014,24220,632,1746.60%85.93,382,0683,605,326

A30AMatriel de stomie digestive12,133787185.185,411168,58694,2088,507,9901.60%8,504,9608,049,0871.70%94.6455,873458,903

A20BNutrition entrale, prestations1,82960.768.594.714,24646,48514,9373,646,1565.40%3,654,2403,568,0924.50%97.686,14878,064

A20ANutrition entrale, consommables dont poches de nutriments1,8116168.593.619,221474,18020,0212,579,2081.80%2,598,4352,539,1611.20%97.759,27340,046

A10CNutrition, dispositifs divers, dont tire-laits10,65141.69.618.53,941125,31236,2561,590,7339.30%1,466,2821,158,4088.40%79307,874432,326

A01*Aliments destins des fins mdicales9325.154.894.668505,658503,329-22.10%503,322503,161-22.20%100161168

A30BStomie digestive, divers31758.247.375.71,4072,6651,806358,52317.80%358,179337,96117.80%94.420,21820,563

A10AAliments sans gluten, soluts de rhydratation et autres63952.538.257.69,92835,69518,843263,858-10.40%162,313128,718-3.50%79.333,595135,141

A40AImplants, anneaux gastriquessssssssssssss

Aide la vie et fauteuils roulants



(en %)

K10Dispositifs daide la vie dont bquilles, dambulateurs119,5207341.459.2261,974917,741352,83720,576,0681.50%19,419,58717,264,0952.50%88.92,155,4923,311,973

K20AFauteuils roulants manuels, location30,03677.539.474.2160,338753,419199,91811,244,2412.30%11,258,40910,046,1260.70%89.21,212,2841,198,115

K20BFauteuils roulants manuels, achat8,79778.444.88315,63320,59618,5115,683,832-5.00%5,130,9125,129,930-4.90%100981553,901

K20CFauteuils roulants lectriques1,23163.762.9891,9402,2562,1963,314,752-4.60%2,251,3892,249,982-6.40%99.91,4071,064,770

K30Autres vhicules pour personnes handicapes (poussettes, tricycles)3,01381.738.683.52,6453,1743,1621,137,21214.00%1,045,2151,043,95212.30%99.91,26393,260

K01*Vhicules pour handicaps physiques15376.551.672.5181-75-76-114,180-7325.20%-42,279-42,007105.10%99.4-272-72,173

Organe des sens et sphre ORL



(en %)

S10BVerres plus de 18 ans474,60859.547.625249,056987,198982,889146,138,457-4.70%6,904,3394,301,7691.60%62.32,602,571141,836,688

S30Ophtalmologie, implants65,74170.7354293,353242,216203,5823,305,17620.50%2,495,9141,635,22818.90%65.5860,6861,669,948

S10AVerres moins 18 ans69,04110.945.63.85,608146,688146,10410,748,710-2.60%2,176,2791,307,743-4.40%60.1868,5369,440,967

S10CMontures moins 18 ans65,20110.945.73.72,55567,53267,5007,623,785-3.70%2,055,0091,234,529-2.80%60.1820,4806,389,256

S10DMontures plus de 18 ans432,6215847.523.3110,524432,258472,63957,113,318-4.70%1,451,646904,5342.20%62.3547,11256,208,784

S20ALentilles3,793463713.58977,4147,117785,085-4.70%290,834178,070-1.40%61.2112,764607,015

S20BOptique divers, dont aides visuelles2,14717.955.115.16885,2274,36286,4604.20%31,40219,6484.50%62.611,75566,812

S10*Verres*2,42749.748.622.21,162-1,724-1,670-225,45838.40%-10,298-5,97878.40%58.1-4,320-219,480

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 ans27,16578.35347.419,12946,50640,58160,339,797-2.30%9,342,8215,932,8227.80%63.53,409,99954,406,975

S40CAudioprothses, accessoires et entretien65,17979.450.249.547,012132,68195,5905,173,1375.90%4,341,6972,741,2142.80%63.11,600,4842,431,923

S40AAudioprothses, moins 20 ans71854.742.856.46551,3231,1612,157,71121.70%1,805,9541,328,00921.50%73.5477,945829,702

S50ADispositifs trachaux, prestation ventilation, prothses respiratoires et vocales1,8987258.582.37,22433,1897,907704,1174.30%699,795685,1704.80%97.914,62518,947

S40*appareils lectroniques de surdit3,97578.951.7493,354-5825,413-230,12451.70%98,79877,02223.10%7821,776-307,146

S50BYoyos11445.755.327.2361771472,3401,8941,53781.1358803

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

Systme cardio-vasculaire



(en %)

C10AValves cardiaques33683.352.186.63023493496,014,86750.00%6,014,8676,010,96450.20%99.93,9043,904

C40BStimulateurs cardiaques double chambre1,91982.658.171.91,3851,9271,9275,892,6982.10%5,892,7685,870,2482.20%99.622,52122,450

C30AStents coronariens actifs (mdicamenteux)2,08373.475.2742,7373,7023,6843,228,34010.70%3,240,9203,239,87011.10%1001,050-11,530

C20AStents vasculaires (rnal, iliaque, fmoral)1,89376.262.686.42,8483,3723,2792,789,7091.30%2,791,6342,790,6741.40%100960-965

C60ASondes dfibrillation et stimulation2,19681.762.875.42,8853,9193,8432,322,327-0.60%2,322,3812,320,447-0.70%99.91,9331,879

C20BStents vasculaires aortiques (abdominal, thoracique)81573.879.475.61,1041,4911,4671,911,59815.30%1,918,2931,917,89215.70%100401-6,294

C40AStimulateurs cardiaques simple chambre67185.264.186.15796726721,730,168-5.40%1,730,2231,725,606-5.40%99.74,6174,563

C30BStents coronariens inactifs8607869.572.29501,3311,317768,997-33.00%778,250777,618-32.30%99.9632-8,621

C40CStimulateurs cardiaques triple chambre16782.167.193.4156167167684,10026.70%684,100684,10026.70%100

C10DGreffons vasculaires et implants intracrniens16864.970.258.3302599535288,296-0.10%288,296288,296-0.10%100

C60BCardio-vasculaire, autres implants, dont ECG5874.758.667.242616187,88115.20%87,88181,83513.60%93.16,0476,047

C50CSystme tlsurveillance triple chambre8073.372.59577818178,73222.70%78,73278,53822.40%99.8194194

C50BSystme tlsurveillance double chambre3469.988.294.132343429,37647.80%29,37629,37647.80%100

C50ASystme tlsurveillance simple chambre2064.7908016202017,2805.30%17,28017,2805.30%100

C70Dispositif d'assistance circulatoire mcanique (DACM)sssssssssssssss

C10BCardio-vasculaire, plaques d'obturation et patchs1576.753.366.710151510,97687.50%10,97610,97687.50%100

C10CImplants de pontagesssssssssssss

Appareil gnito-urinaire



(en %)

G30AGnito-urinaire, matriel pour incontinence14,9117980.381.788,309145,211100,1308,355,923-0.20%8,344,7747,807,758-0.50%93.6537,016548,164

G30BGnito-urinaire, matriel pour sondage vsical9,81477.559.379.852,275186,44063,3307,946,7508.70%7,871,9837,375,8418.60%93.7496,141570,908

G20BGnito-urinaire, lectrostimulation9,7364812.120.82,69615,51611,3611,027,43715.00%997,728770,37713.10%77.2227,351257,060

G20AGnito-urinaire, implants dont grains d'iode67676.161.174.6669902889886,215-3.40%886,215885,491-3.30%99.9725725

G10Dispositifs contraceptifs9,80634.90.14.849010,17610,172539,349-0.50%538,055424,031-0.10%78.8114,023115,318

Prothses rparatrices vise esthtique



(en %)

E30Prothses oculaires et faciales1,48066.265.344.59312,0112,021626,995-2.00%630,929630,919-1.20%10010-3,924

E10AProthses externes mammaires2,89970.20.479.82,4253,1293,025540,387,339,263311,400,91.827,863228,987

E20Postiches2,13065.33.985.21,9042,2752,271933,118-15.70%284,381256,018-7.30%9028,362677,100

E10BImplants mammaires12847.2063.310719218662,619-88.80%62,88662,886-83.50%1000-268

E01*prothses externes non orthopdiques2565.3246822-14-121,163-590.90%1,4151,775580.90%125.5-360-612

Neurologie



(en %)

N10Traitement externe de la douleur6,05057.742.441.412,71753,99729,962623,67514.50%554,920423,21110.60%76.3131,710200,464

N20Neurostimulateurs implants3156.951.629165352321,546-22.00%321,546317,376-22.90%98.74,1704,170

Matriels divers



(en %)

Z03*matriels et appareil pour traitement divers2,24272.847.880.22,8801,048-10,926-106.90%101,487127,516-25.10%125.6-26,030-138,443

Z02*matriels et appareil de contention et de maintien25765.24244.7135552,667-79.40%2,8322,453-71.50%86.6379214

Z01*autres matriels pour traitement domicile5,06679.439.175.210,002-2,706-362,019-205.80%-350,621-289,955-188.40%82.7-60,666-72,064

Ecart TIPS et Prise en charge Exceptionnelle



(en %)

W01*Ecart TIPS1,88169.750.441.31,3053,43880,65812.90%80,65880,65512.90%10033

W02*Prise en charge Exceptionnelle1575.94053.31911-641-137.10%-661-661-138.20%100019

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Source: MSA

Soursce: MSA

Tableau 4

Part du produit au sein du titre en 2015Evolution 2014-2015

rang 2014rang 2015CodeLibellsQt de produitsQt d'actesMontant de la base du rembourse-mentMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du rembourse-mentMontant remboursQt de produitsQt d'actesMontant de base du rembourse-mentMontant rembours

LPPmdicaux

TITRE I - Maintien domicile

211241763LIT MEDICAL, LIT STANDARD, LOCATION HEBDOMADAIRE, LIT ET ACCESSOIRES2,650,977657,48537,246,50433,904,04175.412.30%8.40%9.60%10.00%3.50%-8.90%3.40%3.10%

121160792NUT ORALE, ADULTE, MEL POLY HYPERPROT, HYPERENERG, >OU= 200 ET OU= 200 ET OU = 100CM2, 50 SACHETS X 2220,081161,9072,297,8561,825,28341.81.00%2.10%0.60%0.50%-10.50%-21.50%-11.20%-11.40%

10101378031SPARADRAP NON ELASTIQUE, > OU = 2285CM2 & < 2500CM2194,172137,033359,363267,25527.30.90%1.70%0.10%0.10%-1.80%-12.70%-1.90%-1.80%

12111304736PANSEMENTS HYDROCELLULAIRES, >OU= 63 CM2 ET < 100 CM2, BOITE DE 16175,424135,1034,616,7443,466,683330.80%1.70%1.20%1.00%9.60%3.60%7.30%7.60%

14121353752COMPRESSES NON TISSEES STERILES, > OU = 100CM2, BOITE DE 50 SACHETS X 2151,560106,8281,446,9491,172,03845.20.70%1.40%0.40%0.30%8.90%-3.40%8.20%8.00%

13131145692NUT ORALE, ADULTE, MEL POLY HYPERPROT, HYPERENERG, >OU= 300 ET OU = 10000CM2100,98187,968816,914636,84040.20.50%1.10%0.20%0.20%-5.80%-18.40%-5.80%-5.60%

11151332313BANDES EXTENSIBLES TISSEES OU TRICOTEES, 4 M A L'ETIRAGE ET LARGEUR 0,10 M1,137,74880,550914,922741,30942.15.30%1.00%0.20%0.20%-1.70%-39.80%-1.40%-1.20%

16161298680VHP AVEC 1 ACCESSOIRE, LOCATION HEBDOMADAIRE, < OU = 52 SEMAINES308,72978,8155,079,8374,523,84370.51.40%1.00%1.30%1.30%0.10%-11.10%-0.10%-0.40%

19171113976SOLUTION CARBOXYMETHYLCELLULOSE ET GLYCERINE, ALLERGAN, OPTIVE, FLACON 10ML, B/187,47778,565981,202640,57311.10.40%1.00%0.30%0.20%5.50%4.80%2.90%2.90%

25181132471SOLUTION HYALURONATE SODIUM 0,18%, HORUS, VISMED, FLACON 10 ML, B/188,19776,9831,036,704681,261120.40%1.00%0.30%0.20%26.70%26.50%24.10%23.70%

20191217374LIT, COMPRESSEUR ET SURMATELAS PNEUMATIQUE, LOCATION HEBDOMADAIRE280,96371,9233,095,5012,941,23585.81.30%0.90%0.80%0.90%13.60%-0.30%13.70%13.30%

17201314367PANSEMENTS VASELINES, > OU = 100CM2 & < 275CM2, BOITE DE 10104,82271,8001,553,8111,164,29530.80.50%0.90%0.40%0.30%-1.00%-12.20%-3.20%-3.10%

18211371508COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU = 56CM2 & < 100CM2, 50 SACHETS X 280,95971,157618,246455,75329.70.40%0.90%0.20%0.10%-6.40%-10.40%-6.90%-7.60%

23221330751COMPRESSES NON TISSEES STERILES, > OU= 56CM2 & < 100CM2, BOITE DE 50 SACHETS X 282,43370,153570,319423,73829.80.40%0.90%0.10%0.10%12.20%8.00%11.50%11.60%

22231255682VHP AVEC 1 ACCESSOIRE, LOCATION HEBDOMADAIRE, > 52 SEMAINES266,39365,6402,703,1512,483,13778.51.20%0.80%0.70%0.70%10.20%-4.40%6.90%6.40%

21241326761COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU = 56CM2 &< 100CM2, 10 SACHETS X 286,51563,926173,876114,83713.40.40%0.80%0.00%0.00%-6.20%-8.40%-6.90%-7.00%

27251278654SOULEVE-MALADE, LOCATION HEBDOMADAIRE, > 32 SEMAINES211,33854,1932,289,3012,189,78587.41.00%0.70%0.60%0.60%13.20%-2.50%13.00%12.80%

24261136581OXYGENOTHERAPIE A LONG TERME EN POSTE FIXE209,87654,1229,949,9789,132,91879.31.00%0.70%2.60%2.70%-4.60%-14.90%-5.10%-5.60%

28271296787CANNE METALLIQUE REGLABLE, AVEC APPUI ANTEBRACHIAL OU POIGNET EN T, A L'ACHAT90,97153,9801,101,376750,459210.40%0.70%0.30%0.20%0.90%-1.80%0.30%0.30%

35281344428PANSEMENTS HYDROCELLULAIRES, >OU= 50 CM2 ET < 63 CM2, BOITE DE 1073,31453,026983,901717,04227.60.30%0.70%0.30%0.20%22.40%16.20%19.80%20.90%

26291338385COMPRESSES DE GAZE HYDROPHILE, STERILES, > OU =100CM2, 10 SACHETS X 274,10351,187190,197128,36616.50.30%0.70%0.00%0.00%-6.90%-10.10%-7.50%-7.90%

31301355685COMPRESSES NON TISSEES STERILES, > OU=56CM2 & < 100CM2, BOITE DE 10 SACHETS X 268,44450,738127,24083,91712.80.30%0.60%0.00%0.00%7.80%5.30%7.00%6.80%

Total des 30 premiers produits du titre I12200 0004,890,235170,228,883143,885,06756.60%62.30%43.90%42.20%3.80%-5.50%4.40%3.70%

Source: MSA

* codes issus du recodage (cf. tableau 7, p41)


rang 2014rang 2015CodeLibellsQt de produitsQt d'actesMontant de la base du rembourse-mentMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du rembourse-mentMontant remboursQt de produitsQt d'actesMontant de base du rembourse-mentMontant rembours

LPPmdicaux

TITRE II - Orthses, prothses, appareils de soutien

11210000AORTHESE PETIT APPAREILLAGE721,83628,580,00519,995,70222.124.70%31.50%30.00%0.70%-0.20%-0.60%

222223342MONTURE , > OU = 18 ANS432,261431,8271,238,757770,7934.919.30%14.80%1.40%1.20%1.60%1.60%0.00%0.10%

332227038VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -8,00 A +8,00410,885408,8654,338,2822,708,5595.718.40%14.00%4.80%4.10%4.10%4.40%3.70%3.40%

442259966VERRE BLANC SIMPLE FOYER, >OU =18 ANS,CYLINDRE OU = 18 ANS, SPHERE DE -6,00 A +6,00138,538138,011322,228199,8744.76.20%4.70%0.40%0.30%-5.80%-5.30%-7.50%-8.00%

662290396VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -4,00 A +4,00114,729114,431856,717531,86855.10%3.90%0.90%0.80%-1.80%-1.50%-2.10%-2.40%

772200393VERRE BLANC SIMPLE FOYER, OU= 18 ANS,CYLINDRE OU= 300 ET OU= 300 CM2 ET < 400 CM2, BOITE DE 1048,74227,8513,587,2242,973,40051.20.20%0.40%0.90%0.90%10.60%-2.80%5.80%5.90%

29231144238NUT ORALE, ADULTE, MEL POLY GLUCIDOPROT,, >OU= 200 ET OU= 156 CM2 ET < 200 CM2, BOITE DE 1650,96737,3763,188,2842,575,54846.50.20%0.50%0.80%0.80%8.20%-6.50%4.60%5.40%

25251176876NUTRITION ENTERALE, FORFAIT HEBDOMADAIRE AVEC POMPE OU REGULATEUR DE DEBIT38,28611,7263,186,2783,116,50693.80.20%0.10%0.80%0.90%6.70%7.00%5.60%5.40%

28261217374LIT, COMPRESSEUR ET SURMATELAS PNEUMATIQUE, LOCATION HEBDOMADAIRE280,96371,9233,095,5012,941,23585.81.30%0.90%0.80%0.90%13.60%-0.30%13.70%13.30%

30271347823PANSEMENTS HYDROCELLULAIRES, >OU= 460 CM2, BOITE DE 1026,57013,7652,985,4902,561,67760.40.10%0.20%0.80%0.80%18.90%-1.20%13.70%14.60%

36281182078PERFUSION, ACCESSOIRES A USAGE UNIQUE POUR POSE DE LA PERFUSION243,43529,1322,785,2122,621,177751.10%0.40%0.70%0.80%17.00%-8.20%17.20%16.80%

26291148124INCONTINENCE, STOMIE URINAIRE, 30 POCHES DE JAMBE OU DE NUIT, 30 RACCORDS39,48034,4862,756,3522,533,65577.90.20%0.40%0.70%0.80%-1.20%-6.90%-1.10%-1.10%

27301231782SOULEVE-MALADE, LOCATION HEBDOMADAIRE, < OU = 32 SEMAINES154,58840,4582,712,5802,563,85684.30.70%0.50%0.70%0.80%-1.60%-13.50%-1.60%-1.90%

Total des 30 premiers produits du titre I10,860,0003,836,007238052 088207393 62650.50%49.00%61.40%61.60%3.40%-4.70%2.10%1.30%


rang 2014rang 2015CodeLibellsQt de produitsQt d'actesMontant de la base du rembourse-mentMontant rembours% de produit PEC 100%Qt de produitsQt d'actesMontant de base du rembourse-mentMontant remboursQt de produitsQt d'actesMontant de base du rembour-Montant rembours

LPPmdicauxsement


11210000AORTHESE PETIT APPAREILLAGE721,83628,580,00519,995,70222.124.70%32.00%30.00%0.70%-0.20%-0.60%

22270000AORTHOPROTHESE24,05012,445,94412,446,78599.90.80%14.00%18.70%15.10%9.10%9.20%

332335791AUDIOPROTHESE, APPAREIL DE CLASSE D, > OU = 20 ANS44,98039,2769,030,5505,729,8937.12.00%1.30%10.00%8.60%8.90%10.10%9.40%9.20%

442620400CHAUSSURES ORTHOPEDIQUES SUR MESURE, DE CLASSE B, LA PAIRE5,4475,4144,388,9923,949,89673.60.20%0.20%5.00%5.90%0.10%0.70%0.00%0.00%

552227038VERRE BLANC MULTIFOCAL OU PROGRESSIF, > OU = 18 ANS, SPHERE DE -8,00 A +8,00410,885408,8654,338,2822,708,5595.718.40%14.00%5.00%4.10%4.10%4.40%3.70%3.40%

662340119AUDIOPROTHESE, ENTRETIEN & REPARATIONS, ALLOCATION FORFAITAIRE ANNUELLE121,66285,5374,245,4812,678,8496.15.40%2.90%5.00%4.00%9.30%7.00%3.20%2.80%

1072166740CHUT POUR AUGMENTATION DU VOLUME DE L'AVANT-PIED, L'UNITE77,21843,4962,361,2391,874,96745.83.50%1.50%3.00%2.80%45.20%38.20%45.00%43.90%

782210546MONTURE , < 18 ANS67,52967,5062,055,2611,234,6420.23.00%2.30%2.00%1.90%-2.40%-2.30%-2.50%-2.50%

992140455ORTHESE PLANTAIRE, AU-DESSUS DU 37123,51585,3461,824,6661,145,5046.85.50%2.90%2.00%1.70%-0.20%1.00%0.70%0.60%

8102689974CHAUSSURES ORTHOPEDIQUES SUR MESURE, DE CLASSE A, LA PAIRE2,3972,3801,752,4991,412,08148.80.10%0.10%2.00%2.10%-6.40%-6.30%-9.80%-11.00%

12112355084AUDIOPROTHESE, APPAREIL DE CLASSE D, < 20 ANS1,2601,1091,727,8241,273,31131.10.10%0.00%2.00%1.90%20.70%25.60%20.90%20.90%

11122200393VERRE BLANC SIMPLE FOYER, OU =18 ANS,CYLINDRE OU = 18 ANS, SPHERE DE -4,00 A +4,00114,729114,431856,717531,86855.10%3.90%1.00%0.80%-1.80%-1.50%-2.10%-2.40%

20202107972CORRECTION ORTHOPEDIQUE, PIED, ORTHESE STABILISATRICE DE CHEVILLE, PLAN FRONTAL29,22629,154801,593519,62111.81.30%1.00%1.00%0.80%3.40%3.50%3.40%3.10%

2221200000ADIVERS ORTHESES28,650527,386335,3668.11.00%1.00%0.50%30.50%30.40%29.60%

21222261874VERRE BLANC SIMPLE FOYER, < 18 ANS, SPHERE DE -6,00 A +6,0043,24443,068520,630312,6630.21.90%1.50%1.00%0.50%-5.40%-5.00%-5.50%-5.50%

24232182755COR, ORTHO,, MAIN-POIGNET, ORTHESE STATIQUE, POIGNET-RIGIDE8,1528,044339,358218,91510.70.40%0.30%0.00%0.30%7.30%7.40%7.30%7.00%

23242203240VERRE BLANC SIMPLE FOYER, > OU = 18 ANS, SPHERE DE -6,00 A +6,00138,538138,011322,228199,8744.76.20%4.70%0.00%0.30%-5.80%-5.30%-7.50%-8.00%

26252251545LENTILLE DE CONTACT, FORFAIT ANNUEL, PAR OEIL APPAREILLE7,4147,082289,207176,8273.80.30%0.20%0.00%0.30%-0.90%-1.10%-1.30%-1.50%

28262183855CHUT A DECHARGE DE L'AVANT-PIED, L'UNITE8,2577,393251,415174,46222.80.40%0.30%0.00%0.30%10.00%8.50%9.70%9.30%

29272139943CORRECTION ORTHOPEDIQUE, MAIN, ATTELLE MP, FLEXION, POUCE ABDUCTION5,7535,562249,615161,11510.60.30%0.20%0.00%0.20%8.80%8.50%8.90%9.10%

32282161530CORRECTION ORTHOPEDIQUE, PIED, ATTELLE MONTEE SUR CHAUSSURES3,6883,633237,324159,14817.40.20%0.10%0.00%0.20%14.20%13.10%14.00%13.00%

27292158449ORTHESE PLANTAIRE, MONOBLOC EN RESINE COULEE, MOULAGE DU PIED8,5045,706233,303151,27911.60.40%0.20%0.00%0.20%-0.40%0.40%-11.30%-10.90%

3630230000AAPPAREIL ELECTRONIQUE DE SURDITE5,867224,414157,8346.40.20%0.00%0.20%16.40%34.80%42.90%

Total des 30 premiers produits du titre II2,104,4322,760,25185,553,41862,596,19794.20%94.40%94.00%94.00%2.80%2.50%3.90%3.90%



LPPmdicauxsement

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

113151047GENOU, IMPLANT FEMORAL, BICONDYLIEN, NON CIMENTE3,2653,2654,921,3674,921,0641002.40%2.60%7.00%7.00%-2.80%-4.40%-6.10%-6.10%

223489875STIMULATEUR CARDIAQUE DOUBLE CHAMBRE, TYPE DDDR1,5941,5944,789,7654,771,09498.21.20%1.30%6.80%6.80%5.60%5.50%4.80%4.80%

333165517HANCHE, TIGE STANDARD, COL INCLUS, DROITE, MODULAIRE NON CIMENTEE4,8904,8874,001,0813,999,93399.93.70%3.80%5.70%5.70%-1.60%-4.00%-4.70%-4.70%

443120041HANCHE, COTYLE STANDARD, MODULAIRE, METAL-BACK, SANS INSERT, NON CIMENTE6,5706,5673,859,3583,858,53299.94.90%5.20%5.50%5.50%-2.60%-4.90%-5.70%-5.70%

3553299070BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, EDWARDS SAPIEN 3 + COMMANDER1701703,317,9753,317,9751000.10%0.10%4.70%4.70%750.00%750.00%750.00%758.60%

563127942GENOU, IMPLANT FEMORAL, BICONDYLIEN, CIMENTE2,1222,1222,769,8172,769,5601001.60%1.70%4.00%4.00%9.80%6.60%6.10%6.10%

773183194IMPLANT ENDOVASCULAIRE DIT STENT, AORTIQUE, RENAL, ILIAQUE OU FEMORAL3,1253,0392,512,9682,512,16899.82.30%2.40%3.60%3.60%3.80%3.20%-0.80%-0.80%

683152319GENOU, IMPLANT TIBIAL BICOMPARTEMENTAL, EMBASE METALLIQUE, CIMENTEE3,2223,2222,385,6112,385,31699.92.40%2.50%3.40%3.40%-3.30%-5.50%-6.60%-6.60%

893181870GENOU, IMPLANT BICOMPARTIMENTAL OU INSERT TIBIAL EN POLYETHYLENE SEUL5,8915,8912,143,6422,143,42699.94.40%4.60%3.10%3.10%-0.90%-3.00%-4.20%-4.10%

9103191756GENOU, IMPLANT TIBIAL BICOMPARTIMENTAL, EMBASE METALLIQUE, NON CIMENTEE2,1702,1702,044,1662,043,9811001.60%1.70%2.90%2.90%1.40%-0.60%-2.00%-2.00%

14113235301BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, MEDTRONIC, COREVALVE, AOA96961,873,6801,873,6801000.10%0.10%2.70%2.70%41.20%41.20%41.20%41.20%

10123416340SONDES STIM ATRIALE OU VENTRICULAIRE DROITE HORS VDD, BIPOLAIRES3,4763,4001,855,8721,853,93999.52.60%2.70%2.60%2.60%2.40%2.10%1.20%1.20%

12133111390HANCHE, TETE OU TETE A JUPE, CERAMIQUE5,0205,0151,701,1581,700,81899.93.80%3.90%2.40%2.40%-0.10%-2.20%-3.20%-3.20%

13143442750STIMULATEUR CARDIAQUE SIMPLE CHAMBRE FREQUENCE ASSERVIE, TYPE SSIR (VVIR / AAIR)5645641,414,5461,410,53498.60.40%0.40%2.00%2.00%-7.10%-7.20%-7.80%-7.80%

15153199321HANCHE, TIGE STANDARD, COL INCLUS, DROITE, MODULAIRE, CIMENTEE1,7961,7961,224,9991,224,04099.61.30%1.40%1.70%1.70%5.50%2.30%2.10%2.10%

19163187045EPAULE, TIGE HUMERALE STANDARD, MODULAIRE9059051,017,9771,017,51599.80.70%0.70%1.50%1.50%14.80%6.30%10.90%10.90%

17173140150HANCHE, INSERT EN CERAMIQUE2,9832,9791,016,6491,016,51399.92.20%2.30%1.50%1.50%-1.50%-4.00%-4.60%-4.50%

16183174960HANCHE, TIGE ANATOMIQUE, COL INCLUS, NON CIMENTEE1,0101,010978,363978,3631000.80%0.80%1.40%1.40%-12.10%-13.20%-14.80%-14.80%

20193197753OSTEOSYNTHESE, SYSTEME D'ANCRAGE TENDINEUX OU LIGAMENTAIRE, NON RESORBABLE8,0217,251973,861973,6901006.00%5.70%1.40%1.40%15.80%12.30%13.60%13.60%

23203190857OSTEOSYNTHESE, SYSTEME D'ANCRAGE TENDINEUX OU LIGAMENTAIRE, RESORBABLE4,5184,109836,792836,7921003.40%3.20%1.20%1.20%10.60%11.90%8.50%8.50%

21213137283RACHIS, IMPLANT ANCRAGE, VIS PEDICULAIRE NON CERVICALE4,4983,025818,366818,3661003.40%2.40%1.20%1.20%-3.00%-3.70%-4.40%-4.40%

22223107916HANCHE, TETE OU TETE A JUPE, METALLIQUE3,7383,738732,307731,83599.72.80%2.90%1.00%1.00%-4.90%-7.20%-8.00%-8.00%

25233168042HANCHE, COTYLE DE RECONSTRUCTION, MODULAIRE, METAL-BACK, SANS INSERT NON CIMENTE659659656,178656,1781000.50%0.50%0.90%0.90%6.10%2.30%2.80%2.80%

26243104987GENOU, IMPLANT FEMORAL DE REPRISE BICONDYLIEN, CIMENTE398398573,745573,46299.80.30%0.30%0.80%0.80%-5.50%-8.50%-8.60%-8.60%

18253472685STIMULATEUR CARDIAQUE DOUBLE CHAMBRE FREQ,ASSERV,, BIOTRONIK, EVIA DR-T161161563,662561,54698.20.10%0.10%0.80%0.80%-43.70%-44.10%-44.10%-44.00%

27263184093IMPLANT POUR PLASTIE ENDOCANALAIRE, EXPANSIBLE, METALLIQUE613600538,231537,70599.20.50%0.50%0.80%0.80%0.30%-0.50%0.30%0.50%

29273128976RACHIS, CAGE INTERSOMATIQUE OU EQUIVALENT1,0931,022530,602530,50499.90.80%0.80%0.80%0.80%16.40%15.90%14.70%14.70%

28283157570GENOU, IMPLANT PATELLAIRE EN POLYETHYLENE SEUL3,5553,554481,948481,89599.92.70%2.80%0.70%0.70%-0.10%-2.30%-2.80%-2.70%

30293105811GENOU, EMBASE DE REPRISE, CIMENTEE409409440,295440,2951000.30%0.30%0.60%0.60%0.70%-2.40%-2.70%-2.60%

32303163659ACCESSOIRE POUR IMPLANT ARTICULAIRE, CIMENT AVEC ANTIBIOTIQUE (UNE DOSE)8,5198,201436,099435,92499.86.40%6.50%0.60%0.60%1.30%-1.50%-1.00%-1.00%

Total des 30 premiers produits du titre III85,05181,81951,411,08251,376,64163.70%64.20%73.30%73.30%11.30%9.10%1.10%1.10%

Source: MSA



LPPmdicauxsement

TITRE IV - Achats et rparations de fauteuils

114118193VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER INCLINABLE4,8034,7622,869,1842,868,94210018.50%20.00%34.20%34.00%-4.70%-6.90%-4.80%-4.80%

224122757VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, VERIN PNEUMATIQUE2842841,118,3951,118,3951001.10%1.20%13.30%13.00%1.10%0.70%1.00%1.00%

334107723VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE1,8571,8481,030,2361,030,01299.97.20%7.80%12.30%12.00%-6.10%-7.10%-6.80%-6.80%

544252810VHP, POUSSETTE OU FAUTEUIL NON REGLABLE, DOSSIER OU SIEGE RIGIDES OU NON1,9291,929688,460687,74699.57.40%8.10%8.20%8.00%20.30%20.30%20.30%20.30%

454130136VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, PLATINES CRANTEES182182624,629623,23499.50.70%0.80%7.40%7.00%-12.50%-12.50%-13.00%-13.20%

664342654VHP, PROPULSION MANUELLE, REPOSE-JAMBE DROIT OU GAUCHE, REPOSE-PIED ARTICULE3,5212,323372,764372,67910013.60%9.80%4.40%4.00%-3.80%-9.60%-3.90%-3.90%

774233570VHP, CHASSIS ROULANT DESTINE A RECEVOIR LE SYSTEME DE SOUTIEN DU CORPS918915242,053241,78999.73.50%3.80%2.90%3.00%-6.10%-6.50%-5.90%-5.80%

984375116VHP, PROPULSION MANUELLE, PLIANT, COUSSIN DE SIEGE OU DE DOSSIER AVEC HOUSSE4,0923,671143,008142,78499.715.80%15.40%1.70%2.00%-7.30%-9.90%-7.40%-7.50%

1194307994VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION COMPOSANTS ELECTRIQUES539519135,421135,4211002.10%2.20%1.60%2.00%5.30%3.60%5.90%5.90%

10104327382VHP, PROPULSION MANUELLE, GOUTTIERE DROITE OU GAUCHE1,059788126,434126,31599.94.10%3.30%1.50%2.00%-10.20%-13.60%-11.00%-11.00%

8114168966VHP, PROPULSION ELECTRIQUE, VERTICALISATEUR ELECTRIQUE2525124,630124,6301000.10%0.10%1.50%1.00%-24.20%-24.20%-28.30%-28.30%

14124302152VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, AUTRES REPARATIONS DONT SELLERIE1,4481,400116,423116,4231005.60%5.90%1.40%1.00%11.50%10.10%10.10%10.10%

12134325302VHP, PROPULSION MANUELLE, APPUI-TETE1,7701,767112,190112,10199.96.80%7.40%1.30%1.00%-6.80%-11.70%-6.80%-6.90%

13144122473VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE, ARTICULATION MEDIANE15715794,74294,7421000.60%0.70%1.10%1.00%-17.80%-19.50%-17.80%-17.80%

15154339681VHP, PROPULSION ELECTRIQUE, BOITIER DE COMMANDE PERSONNALISE11811884,28384,2831000.50%0.50%1.00%1.00%0.90%0.00%-1.70%-1.70%

16164307824VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, REPARATION DE ROUES1,0701,00965,91165,9111004.10%4.20%0.80%1.00%2.30%2.20%4.00%4.00%

20174222803VHP, TRICYCLE A PROPULSION MANUELLE OU PODALE, > OU = 38 CM ET < 90 CM10010064,17364,1731000.40%0.40%0.80%1.00%40.80%40.80%43.20%43.20%

19184371555VHP, PROPULSION MANUELLE, PLIANT, SYSTEME DE CONDUITE A DOUBLE MAIN COURANTE18718750,70650,7061000.70%0.80%0.60%1.00%12.00%12.00%11.90%11.90%

18194348622VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, HORS ROUES ET COMPOSANTS ELECTRIQUES59156745,16345,1631002.30%2.40%0.50%1.00%5.30%2.50%-1.50%-1.50%

17204300348VHP, PROPULSION MANUELLE, DISPOSITIF DE PROPULSION PAR MOTEUR ELECTRIQUE161634,99234,9921000.10%0.10%0.40%0.00%-36.00%-36.00%-36.00%-36.00%

22214179540VHP, PROPULSION MANUELLE, POUR ACTIVITES PHYSIQUES ET SPORTIVES535329,62629,6261000.20%0.20%0.40%0.00%-10.20%-10.20%-10.20%-10.20%

24224183434VHP, PROPULSION MANUELLE, VERTICALISATEUR ELECTRIQUE121229,10129,1011000.00%0.10%0.30%0.00%33.30%33.30%33.30%33.30%

23234389845VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION DE ROUES47145528,99228,98099.81.80%1.90%0.30%0.00%7.50%8.30%9.70%9.70%

28244134364VHP, PROPULSION MANUELLE, EVOLUTIF, POUR ENFANT A PARTIR DE 18 MOIS232322,13122,1311000.10%0.10%0.30%0.00%64.30%64.30%76.40%76.40%

27254329040VHP, PROPULSION MANUELLE, TABLETTE COMPLETE AVEC SON MONTAGE25425419,51719,5171001.00%1.10%0.20%0.00%9.00%2.00%9.00%9.00%

25264261051VHP, POUSSETTE MULTIREGLABLE & EVOLUTIVE, < 16 ANS191918,24618,2461000.10%0.10%0.20%0.00%-13.60%-13.60%-13.80%-13.80%

26274359293VHP, PROPULSION MANUELLE, PLIANT, SYSTEME DE CONDUITE A LEVIER LATERAL393916,72516,7251000.20%0.20%0.20%0.00%-11.40%-11.40%-11.40%-11.40%

38284111854VHP, PROPULSION ELECTRIQUE, A DOSSIER NON INCLINABLE6616,21716,2171000.00%0.00%0.20%0.00%500.00%500.00%500.00%500.00%

29294371408VHP, PROPULSION MANUELLE, REPOSE-JAMBE DROIT OU GAUCHE, REPOSE-PIED NON ARTICULE15813312,30512,3051000.60%0.60%0.10%0.00%-0.60%5.60%-0.60%-0.60%

31304255116VHP, POUSSETTE OU FAUTEUIL, < 16 ANS, DOSSIER OU DOSSIER ET SIEGE INCLINABLES202011,48411,4841000.10%0.10%0.10%0.00%25.00%25.00%-1.00%-1.00%

Total des 30 premiers produits du titre IV25,72123,5818,348,1398,344,77399.30%99.30%99.20%96.00%-2.00%-4.40%-3.50%-3.50%

Tableau 6

Part du produit au sein du titre en 2015

CodeLibellsQt de produitsQt d'actesMontant prsent au rembour-Evolution 2014Montant rembour-Montant rembours% de produit PEC 100%Qt de produitsQt d'actes% montant prsent au rembour-Montant de la base du rembourse-mentMontant rembours

LPPmdicauxsement2015sablesement

TITRE I - Maintien domicile

1138315OXYGENOTHERAPIE A LONG TERME, DEAMBULATION, SCALEO, INOGEN ONE G3,1,759386135,44325029%135,443124,67881.40.00%0.00%0.00%0.00%0.00%

1188767PRESSION POSITIVE CONTINUE + INVACARE SOL O23437629,7732707%29,73727,156750.00%0.00%0.00%0.00%0.00%

1116680OXYGENOTHERAPIE A LONG TERME, DEAMBULATION, CHART SEQUAL, ECLIPSE 31,26828497,6361821%97,63691,35389.90.00%0.00%0.00%0.00%0.00%

1133430OXYGENOTHERAPIE A LONG TERME, DEAMBULATION DEVILBISS HEALTHCARE, IFILL1,04821780,6961618%80,69674,382780.00%0.00%0.00%0.00%0.00%

1103720VENTILATION ASSISTEE, < 12 HEURES + PHILIPS, ULTRAFILL,2596028,5451489%28,54524,442700.00%0.00%0.00%0.00%0.00%

1192020SOLUTION A USAGE OPHTALMIQUE, SANTEN, CATIONORM, FLACON MULTIDOSES STERILE 10 ML10,3019,443142,9601407%115,54375,04810.50.00%0.10%0.00%0.00%0.00%

1118614PPC, APNEE SOMMEIL, PATIENT NON TELEOBSERVE (9,4) + SCALEO, INOGEN ONE G245311239,1681329%39,16836,88182.10.00%0.00%0.00%0.00%0.00%

1119134VENTILATION ASSISTEE, < 12 HEURES + CHART SEQUAL, ECLIPSE 355518860,9191192%60,91959,31395.70.00%0.00%0.00%0.00%0.00%

1100028SOLUTION A USAGE OPHTALMIQUE, SANTEN, CATIONORM, BOITE DE 30 UNIDOSES, 0,4 ML7,1495,168108,945633%34,24122,1049.50.00%0.10%0.00%0.00%0.00%

1167890VENTILATION ASSISTEE, INFERIEUR A 12 HEURES + SCALEO, INOGEN ONE G250512455,329566%55,32953,48691.10.00%0.00%0.00%0.00%0.00%

1141330NUT ORALE, ADULTE, MEL POLY HYPERPROTIDIQUE HYPERENERGET, CONCENTRE, 200 ML, B/481,34432,4411,043,863557%1,043,892894,65561.30.40%0.40%0.30%0.30%0.30%

1126708VENTILATION ASSISTEE, < 12 HEURES + DEVILBISS HEALTHCARE, IFILL1874220,572431%20,57218,05566.70.00%0.00%0.00%0.00%0.00%

1145410NUTRITION PARENTERALE 150 CM2, 5 SOINS24,15210,025250,009113%249,977203,87446.70.10%0.10%0.10%0.10%0.10%

1324213SYSTEME COMPRESSION VEINEUSE, URGO, URGOK2 LATEX FREE 25-32CM, LG 10CM2,88818160,054108%59,46453,57553.60.00%0.00%0.00%0.00%0.00%

1184315OXYGENOTHERAPIE A LONG TERME, DEAMBULATION, PHILIPS, ULTRAFILL76818958,982102%59,13654,54783.60.00%0.00%0.00%0.00%0.00%

1162093PRESSION POSITIVE CONTINUE + VENTURE HOMEFILL II2,726692236,190100%236,120215,19581.20.00%0.00%0.10%0.10%0.10%

1380915SET DE DETERSION POUR PLAIE CHRONIQUE, PEAU SAINE, > 150 CM2, 5 SOINS25,3099,923262,11982%261,947219,96552.90.10%0.10%0.10%0.10%0.10%

1114237NUT ORALE, ENFANT DE MOINS DE 1 AN, NUTRICIA, NEOCATE, BTE 400 G1,99356298,19770%85,18154,5259.60.00%0.00%0.00%0.00%0.00%

1353485PANSEMENT A BASE D'ACIDE HYALURONIQUE, FIDIA, EFFIDIA, TUBE 100G,2,8832,41627,39067%27,27719,56823.80.00%0.00%0.00%0.00%0.00%

Total des 30 premiers produits du titre I215,81482,5485,784,495,5,668,6485,099,9850.70%0.80%1.30%1.30%1.40%

Source: MSA





2304997PROTHESE OSTEO-INTEGREE, PRODITION, PONTO, PROCESSEUR111033,245463.50%9,9006,660200.00%0.00%0.00%0.00%0.00%

2712325PIED RESTITUTION ENERGIE, CLASSE III, OSSUR, RE-FLEX.8822,511305.10%22,51122,5111000.00%0.00%0.00%0.00%0.00%

2545459PROTHESE OCULAIRE PALPEBRO-ORBITAIRE, SUR DEVIS4421,011192.90%21,01121,0111000.00%0.00%0.00%0.00%0.00%

2145524COR. ORTHO., MAIN-POIGNET, ORTHESE DYNAMIQUE, FLEXION MP + EXT.IP408400148,812155.20%40,93628,42022.10.00%0.00%0.00%0.00%0.00%

2734700PIED RESTITUTION ENERGIE, CLASSE III, OSSUR, VARI-FLEX.282878,788135.10%78,78878,7881000.00%0.00%0.00%0.10%0.10%

2752187PIED RESTITUTION ENERGIE, CLASSE III, OTTO BOCK, TRITON9925,32551.30%25,32525,3251000.00%0.00%0.00%0.00%0.00%

2794487PIED RESTITUTION ENERGIE, CLASSE II, OTTO BOCK, TRIAS 1C30242424,85350.80%24,85324,8531000.00%0.00%0.00%0.00%0.00%

2732428PIED RESTITUTION ENERGIE, CLASSE II, OSSUR, SURE-FLEX343235,23348.70%35,23335,2331000.00%0.00%0.00%0.00%0.10%

2112269VETEMENT COMPRESSIF, GANT OUVERT OU FERME35520030,97046.10%29,48225,98962.90.00%0.00%0.00%0.00%0.00%

2167678VETEMENT COMPRESSIF, GILET SANS MANCHE19314632,24444.00%31,85527,62960.80.00%0.00%0.00%0.00%0.00%

2479573PROTHESE RESPIRATOIRE, K7 USAGE UNIQUE, ATOS, PROVOX HME, ECH, LES 2090119234,54442.00%34,54434,39197.90.00%0.00%0.00%0.00%0.10%

2166740CHUT POUR AUGMENTATION DU VOLUME DE L'AVANT-PIED, L'UNITE77,21843,4962,880,20239.70%2,361,2391,874,96745.83.50%1.50%0.80%2.60%2.80%

200000ADIVERS ORTHESES28,6502,064,73833.50%527,386335,3668.11.00%0.60%0.60%0.50%

2149440COR. ORTHO., MAIN-POIGNET, ATTELLE, FLEXION MP + EXT. POIGNET1,2781,241110,19029.60%101,36568,390180.10%0.00%0.00%0.10%0.10%

2451385PROTHESE RESPIRATOIRE, SUPPORT ADHESIF, ATOS, PROVOX HME XTRABASE, LES 2054312033,61227.20%33,61233,6121000.00%0.00%0.00%0.00%0.10%

2594044PROTHESE OCULAIRE DE RECOUVREMENT, RENOUVELLEMENT AVEC PRISE D'EMPREINTE494945,02025.60%44,92044,9201000.00%0.00%0.00%0.00%0.10%

230000AAPPAREIL ELECTRONIQUE DE SURDITE5,867197,10323.10%224,414157,8346.40.20%0.10%0.20%0.20%

220000GVERRES UNIFOCAUX OP3 (CMU)61448,08521.80%4,5512,7751.80.00%0.00%0.00%0.00%

2355084AUDIOPROTHESE, APPAREIL DE CLASSE D, < 20 ANS1,2601,1092,055,47821.20%1,727,8241,273,31131.10.10%0.00%0.60%1.90%1.90%

220000FVERRES UNIFOCAUX OP2 (CMU)11,198294,76920.30%44,30327,4414.20.40%0.10%0.00%0.00%

2147629COQUE TALONNIERE AVEC MOULAGE27518920,78118.60%12,2699,457410.00%0.00%0.00%0.00%0.00%

220000KMONTURE (CMU)13,149507,93417.60%42,17026,3175.30.50%0.10%0.00%0.00%

2445350PROTHESE DE SEIN, EN MATERIAU SOLIDE OU DE FORTE VISCOSITE1,7631,707321,19915.90%123,024112,20476.90.10%0.10%0.10%0.10%0.20%

2486366PROTHESE RESPIRATOIRE, SUPPORT ADHESIF, ATOS, FLEXIDERM, PROVOX HME, LES 2077118947,72514.70%47,72547,32995.20.00%0.00%0.00%0.10%0.10%

2165194CORRECTION ORTHOPEDIQUE, MAIN, ATTELLE MP, FLEXION1,1151,09842,77914.50%40,92527,17315.70.00%0.00%0.00%0.00%0.00%

2116741COR. ORTHO., MAIN-POIGNET, ORTHESE DE POSITIONNEMENT, POIGNET-MAIN-DOIGT58055235,31714.50%33,88022,48614.30.00%0.00%0.00%0.00%0.00%

220000IVERRES UNIFOCAUX OP5 (CMU)7,875516,70414.30%84,54753,4237.10.30%0.10%0.10%0.10%

2152211CORRECTION ORTHOPEDIQUE, GENOU, ATTELLE ET ORTHESE ARTICULEE11,99611,6771,325,69713.90%1,225,722809,75014.60.50%0.40%0.40%1.40%1.20%

2622160CHAUSSURES ORTHOPEDIQUES & APPAREIL PODO-JAMBIER, FRAIS D'EXPEDITION/ACCESSOIRES1,3171,31720,62813.30%20,63118,44770.10.10%0.00%0.00%0.00%0.00%

2104637COR. ORTHO., MAIN-POIGNET, ATTELLE, EXTENSION MP + POIGNET + POUCE ABDUCTION1,6121,562137,44513.00%127,78383,99213.60.10%0.10%0.00%0.10%0.10%

Total des 30 premiers produits du titre II101,752132,71211,192,9417,182,7285,360,0034.50%4.50%2.90%7.30%7.70%

Source: MSA

* codes issus du recodage (cf. tableau 7, p41)



TITRE III Produits implantables

3195843ENDOPROTHESE CORONAIRE, STENT LIB, SIROLIMUS, BIOTRONIK, ORSIRO, DIAM 2,25MM777767,3751440.00%67,37567,3751000.10%0.10%0.10%0.00%0.10%



3239865BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, EDWARDS SAPIEN 3 + CERTITUDE1818351,315800.00%351,315351,3151000.00%0.00%0.50%0.00%0.50%

3494066MONITEUR ECG IMPLANTABLE, MEDTRONIC, REVEAL XT181822,517800.00%22,51720,76561.10.00%0.00%0.00%0.00%0.00%

3299070BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, EDWARDS SAPIEN 3 + COMMANDER1701703,317,975750.00%3,317,9753,317,9751000.10%0.10%4.70%0.00%4.70%


3424462STIMULATEUR CARDIAQUE TRIPLE CHAMBRE, SAINT JUDE, ALLURE QUADRA,5757228,000714.30%228,000228,0001000.00%0.00%0.30%0.00%0.30%

3451810STIMULATEUR CARDIAQUE DE RESYNCHRONISATION VENTRICULAIRE, ST JUDE, ALLURE242496,000700.00%96,00096,0001000.00%0.00%0.10%0.00%0.10%


3333073ALLOGREFFE VASCULAIRE, VEINE SAPHENE, NON CRYOCONSERVEE BIOPROTECT5654111,123216.30%111,123111,1231000.00%0.00%0.20%0.00%0.20%

3100156ENDOPROTHESE AORTIQUE, COOK FRANCE, ZENITH FLEX, ZTRAK, CORPS BIFURQUE8825,468166.70%25,46825,4681000.00%0.00%0.00%0.00%0.00%

3288467BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, MEDTRONIC, COREVALVE EVOLUT, AOA5597,588150.00%97,58897,5881000.00%0.00%0.10%0.00%0.10%

3161028ENDOPROTHESE AORTIQUE, VASCUTEK, ANACONDA, CORPS BIFURQUE ONE LOK,212166,85490.90%66,85466,8541000.00%0.00%0.10%0.00%0.10%

3125943ENDOPROT CORONAIRE, STENT LIB,ZOTAROLIMUS, MEDTRONIC, RESOLUTE INTEGRITY,4,00 MM626254,25089.90%54,25054,2501000.00%0.00%0.10%0.00%0.10%

3133865ENDOPROT, CORONAIRE, STENT LIB, EVEROLIMUS,BOSTON,PROMUS PREMIER, DIAM 4,00 MM707061,38072.30%61,45061,27598.60.10%0.10%0.10%0.00%0.10%

3465946NEUROMODULATEUR DES RACINES SACREES, MEDTRONIC,INTERSTIM+ELECT, TEST-PERMANENTE,5537,19566.70%37,19537,1951000.00%0.00%0.10%0.00%0.10%

3192603ENDOPROTHESE AORTIQUE, VASCUTEK, ANACONDA, JAMBAGE ILIAQUE EVASE PROGRESSIF323032,09760.00%32,09732,0971000.00%0.00%0.00%0.00%0.00%

3410218NEUROSTIMU, MEDUL, MEDTRONIC, RESTORESENSOR SURESCAN MRI, SYST, COMPLET + ACCES3362,55050.00%62,55062,5501000.00%0.00%0.10%0.00%0.10%

3152779ENDOPROT CORONAIRE, STENT LIB D'EVEROLIMUS,ABBOTT,XIENCE XPEDITION,DIAM 3,5 MM269266234,70349.40%236,175236,1751000.20%0.20%0.30%0.00%0.30%

3187737ENDOPROTHESE AORTIQUE, COOK FRANCE, ZENITH SPIRAL-Z, JAMBAGE908890,27347.50%90,27390,2731000.10%0.10%0.10%0.00%0.10%

3161554ENDOPROTHESE AORTIQUE, VASCUTEK, ANACONDA, JAMBAGE222222,06746.70%22,06722,0671000.00%0.00%0.00%0.00%0.00%

3177615ENDOPROTHESE AORTIQUE, COOK FRANCE, ZENITH LOW PROFILE, CORPS BIFURQUE,292992,32245.00%92,32292,3221000.00%0.00%0.10%0.00%0.10%

3143148HANCHE, TIGE DE RECONSTRUCTION, COL INCLUS, DROITE, CIMENTEE222223,36942.50%23,36923,3691000.00%0.00%0.00%0.00%0.00%

3456628SYSTEME DE TELESURVEILLANCE POUR DCI TRIPLE CHAMBRE, MEDTRONIC, CARELINK,272726,24442.10%26,24426,2441000.00%0.00%0.00%0.00%0.00%

3235301BIOPROTHESE VALVULAIRE, TRANSCUTANEE, AORTIQUE, MEDTRONIC, COREVALVE, AOA96961,873,68041.20%1,873,6801,873,6801000.10%0.10%2.70%0.00%2.70%

3189050GENOU, IMPLANT MENISCAL, ANCRE RESORBABLE OU NON, SMITH & NEPHEW, FAST-FIX 36042639997,98037.90%97,98097,9801000.30%0.30%0.10%0.00%0.10%

3318091TETE FEMORALE, COMPLETE OU 2 HEMITETES AVEC COL, TBF, PHOENIX484854,44436.90%54,44454,4441000.00%0.00%0.10%0.00%0.10%

3488864STIMULATEUR CARDIAQUE DOUBLE CHAMBRE MONOSONDE FREQ, ASSERV, TYPE VDDR4848133,95835.70%133,958132,83095.80.00%0.00%0.20%0.00%0.20%

3165173ENDOPROT CORONAIRE, STENT LIB EVEROLIMUS,ABBOTT,XIENCE XPEDITION,DIAM 4,0 MM747364,73035.20%64,94064,9401000.10%0.10%0.10%0.00%0.10%

Total des 30 premiers produits du titre III2,1142,0777,640,096,7,642,0847,639,030,1.40%1.40%10.60%0.00%10.60%




TITRE IV - Achats et rparations de fauteuils

4134364VHP, PROPULSION MANUELLE, EVOLUTIF, POUR ENFANT A PARTIR DE 18 MOIS232339,26296.20%22,13122,1311000.10%0.10%0.40%0.30%0.30%

4183434VHP, PROPULSION MANUELLE, VERTICALISATEUR ELECTRIQUE121242,73146.40%29,10129,1011000.00%0.10%0.40%0.30%0.30%

4222803VHP, TRICYCLE A PROPULSION MANUELLE OU PODALE, > OU = 38 CM ET < 90 CM10010099,64029.70%64,17364,1731000.40%0.40%1.00%0.80%0.80%

4339681VHP, PROPULSION ELECTRIQUE, BOITIER DE COMMANDE PERSONNALISE118118127,81021.30%84,28384,2831000.50%0.50%1.30%1.00%1.00%

4252810VHP, POUSSETTE OU FAUTEUIL NON REGLABLE, DOSSIER OU SIEGE RIGIDES OU NON1,9291,929694,67220.70%688,460687,74699.57.40%8.10%6.90%8.20%8.20%

4389845VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION DE ROUES47145534,02118.00%28,99228,98099.81.80%1.90%0.30%0.30%0.30%

4371555VHP, PROPULSION MANUELLE, PLIANT, SYSTEME DE CONDUITE A DOUBLE MAIN COURANTE18718753,20616.70%50,70650,7061000.70%0.80%0.50%0.60%0.60%

4122757VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, VERIN PNEUMATIQUE2842841,740,11616.30%1,118,3951,118,3951001.10%1.20%17.40%13.30%13.30%

4302152VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, AUTRES REPARATIONS DONT SELLERIE1,4481,400123,87815.30%116,423116,4231005.60%5.90%1.20%1.40%1.40%

4307994VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, REPARATION COMPOSANTS ELECTRIQUES539519167,87911.20%135,421135,4211002.10%2.20%1.70%1.60%1.60%

4307824VHP, PROPULSION MANUELLE, FORFAIT ANNUEL, REPARATION DE ROUES1,0701,00970,2009.20%65,91165,9111004.10%4.20%0.70%0.80%0.80%

4118193VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER INCLINABLE4,8034,7623,078,006-3.90%2,869,1842,868,94210018.50%20.00%30.70%34.20%34.20%

4342654VHP, PROPULSION MANUELLE, REPOSE-JAMBE DROIT OU GAUCHE, REPOSE-PIED ARTICULE3,5212,323380,446-4.50%372,764372,67910013.60%9.80%3.80%4.40%4.40%

4233570VHP, CHASSIS ROULANT DESTINE A RECEVOIR LE SYSTEME DE SOUTIEN DU CORPS918915246,854-5.80%242,053241,78999.73.50%3.80%2.50%2.90%2.90%

4348622VHP, PROPULSION ELECTRIQUE, FORFAIT ANNUEL, HORS ROUES ET COMPOSANTS ELECTRIQUES59156750,736-5.90%45,16345,1631002.30%2.40%0.50%0.50%0.50%

4375116VHP, PROPULSION MANUELLE, PLIANT, COUSSIN DE SIEGE OU DE DOSSIER AVEC HOUSSE4,0923,671160,125-6.50%143,008142,78499.715.80%15.40%1.60%1.70%1.70%

4107723VHP, PROPULSION MANUELLE, PLIANT, A DOSSIER NON INCLINABLE1,8571,8481,154,383-6.90%1,030,2361,030,01299.97.20%7.80%11.50%12.30%12.30%

4325302VHP, PROPULSION MANUELLE, APPUI-TETE1,7701,767116,211-8.40%112,190112,10199.96.80%7.40%1.20%1.30%1.30%

4327382VHP, PROPULSION MANUELLE, GOUTTIERE DROITE OU GAUCHE1,059788132,237-10.00%126,434126,31599.94.10%3.30%1.30%1.50%1.50%

4130136VHP, PROPULSION ELECTRIQUE, ASSISE ADAPTEE, DOSSIER REGLABLE, PLATINES CRANTEES182182723,252-11.70%624,629623,23499.50.70%0.80%7.20%7.40%7.40%

Total des 20 premiers produits du titre IV24,97422,8599,235,6657,969,6547,966,28896.30%96.10%92.10%94.80%94.80%

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 jointeTableau de bord LPP 2015 avec SS.xlsx

6

1. La dpense globale de la LPP

Rpartition de la dpense totale de la LPP en 2015 (en millions deuros)

Dpense

(montant prsent au remboursement)

Remboursable (base de

remboursement)

Montant rembours

Ticket modrateur

Dpassement

I- Maintien domicile 392,3 388,0 337,5 50,5 4,3

II- Orthses, appareils de soutien et prothses externes 368,4 90,1 66,6 23,9 278,3

III- Produits implantables (en sus des soins en tablissements) 70,0 70,0 69,9 0,1 0,0

IV- Achats et rparations des fauteuils roulants 10,1 8,3 8,3 0,0 1,8

TOTAL 840,8 556,4 482,3 74,5 284,4

Source : MSA

Source : MSA

7

2. Vue Assurance Maladie

Rpartition de la base de remboursement de la LPP en 2015 (en millions deuros)

TITRES Quantit dactes Base de

remboursement (remboursable)

Montant rembours

Ticket modrateur

% de produits pris en charge

100%

I- Maintien domicile 7 855 862 388,0 337,5 50,5 56,5

II- Orthses et prothses externes 2 919 905 90,1 66,7 23,9 11,5

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

126 973 70,0 69,9 0,1 99,5

IV- Achats et rparations des fauteuils roulants 23 793 8,3 8,4 0,0 99,9

TOTAL 10 926 533 556 483 75

Source : MSA

Source : MSA

8

Evolution 2014 - 2015

TITRE Quantit dactes

Base de remboursement (remboursable)

Montant rembours

Ticket modrateur

I- Maintien domicile -6,1% +3,2% +2,9% +5,0%

II- Orthses, appareil de soutien et prothses externes +2,2% +3,4% +4,4% +3,5%

III- Produits implantables (en sus des soins en tablissements) -0,6% +1,4% +1,3% +0,0%

IV- Achats et rparations des fauteuils roulants -4,6% -4,6% -3,4% +0,0%

TOTAL -3,9% 2,9% 2,8% 4,5%

Source : MSA

Source : MSA

Source : MSA

9

3. Vue Assur

Rpartition de la dpense LPP en 2015 (en millions deuros)

TITRES Quantit dactes Montant

prsent au remboursement

Montant rembours

Taux de reste charge

I- Maintien domicile 7 855 862 392,30 337,50 14,2%

II- Orthses, appareils de soutien et prothses externes 2 919 905 368,40 66,60 81,9%

III- Produits implantables (en sus des soins en tablissements) 126 973 70,00 69,90 0,1%

IV- Achats et rparations des fauteuils roulants 23 793 10,10 8,30 15,8%

TOTAL 10 926 533 841 482 42,7%

Source : MSA

Source : MSA

10

Evolution 2014 - 2015

TITRE Quantit dactes

Montant prsent au

remboursement

Montant rembours

Reste charge

I- Maintien domicile -6,1% 2,8% 2,9% 3,9%

II- Orthses, appareils de soutien et prothses externes 2,2% -2,6% 4,2% -3,9%

III- Produits implantables (en sus des soins en tablissements) -0,5% 1,4% 1,3% 0,0%

IV- Achats et rparations des fauteuils roulants -4,6% -3,8% -4,6% -5,9%

TOTAL -3,9% 0,2% 2,7% -2,8%

Source : MSA

Source : MSA

Source : MSA

11

ANNEXES

Tlcharger les donnes au format Excel :

Donnees 2015



Quantit de produitEvolution quantit de produitMontant remboursEvolution du montant rembours

201544,9809%5,729,8939%

201441,3059%5,246,5129%

201337,8873%4,821,4303%

201236,839-1%4,698,585-5%

Depense globale

TitreDpense(montant prsent au remboursement)Remboursable(base de remboursement)Montant remboursTicket modrateurMontant du dpassement

1- Maintien domicile392.3388.0337.550.54.3

2- Orthses, appareil de soutien et prothses externes368.490.166.623.9278.3

3- Produits implantables (en sus des soins en tablissements)70.070.069.90.10.0

4- Achats et rparations des fauteils roulants10.18.38.30.01.8

Total840.8556.4482.374.5284.4

Vue assurance maladie

TitreQuantit d'actesBase de rembourse-mentMontant remboursTicket modrateurPart de prise en charge 100% (en %)

I- Maintien domicile7855862388.0337.550.556.5

II- Orthses, appareils de soutien et prothses externes291990590.166.723.911.5

III- Produits implantables (en sus des soins en tablissements)12697370.069.90.199.5

IV- Achats et rparations des fauteuils roulants237938.48.40.099.9

TOTAL10,926,53355748375

Evolution 2014-2015



2- Orthses, appareil de soutien e

Documents

Tableau de bord - statistiques.msa.fr · Tableau de bord LPP La liste des produits et prestations remboursés par le régime agricole en 2015 DIRECTION DES ETUDES, DES REPERTOIRES