1.1 Definition and scope of the study

Medical biology laboratories, formerly called medical analysis laboratories, are places whose function is the realization of diagnoses and medical follow-ups from samples of various human biological fluids. They are managed by biologists.

The French market includes suppliers of reagents and consumables (gloves, masks, etc.), various laboratory groups, sampling sites, technical platforms and finally government agencies (the French Health Insurance).

The turnover of the activity in France has experienced strong growth thanks in particular to Covid PCR tests (120 million tests were performed between May 2020 and the end of 2022, generating strong revenues for the laboratories and representing 25% of the laboratories' turnover). This strong growth attracts many investors, such as Ardian or the BPI, who see a high profitability.

At the same time, the market is undergoing restructuring, the number of laboratories has dropped considerably over the last 10 years and mergers and acquisitions have multiplied. For example, in June 2022, Innovie acquired Biocolinic laboratories. Nevertheless, the number of sampling sites and the number of employees remain stable despite the rationalization of the sector.

In 2022 and 2023, the sector's revenue is down compared to 2020 and 2021 but should reach a level well above 2019.

In this context, where medical biology laboratories have benefited from strong revenues during the health crisis and where the Assurance Maladie has disbursed 7.3 billion euros to finance tests [Alternatives économiques], the Social Security financing bill for 2023 aims to reduce the fees for routine medical biology in order to achieve savings of 250 million euros. The announcement of this measure has led to strong tensions between the government and representatives of the sector.

1.2 Health expenditure in the EU

Europe presents a rather large panorama of medical biology laboratories. There are many differences between countries. These differences are reflected in the health care systems and the divergence in health care spending by European country.

An article from EM consulte provides a typology of health systems in Europe:

The Bismarckian wage-based ...

1.3 Medical laboratories in the consumption of medical care and goods

Each year, the Institute of Information and Professional Conjunctures (***) publishes a report on the Extra-Hospital Medical Biology Laboratories.

Similarly, each year the DREES publishes the results of the health accounts. The **** edition: Health spendings in **** reports and updates health data.

The annual reports of the I+C (***) and the DREES data ...

1.4 The profession's turnover

The latest I+C annual industry reports provide us with the evolution of the turnover of medical laboratories.

evolution of the turnover of medical laboratories (***) France, **** / **** - ****, billion euros Source: ****

Revenues have risen sharply in recent years after a stable period to reach €** billion in ****. This strong increase in revenue in ...

1.5 Biology laboratories in high demand in 2020

Analytical laboratories have been at the heart of the global pandemic. It is clear that they have not suffered too much from the crisis benefiting both from the continuity of activity even during containment but also from the increased demand for Covid-** testing.

The test was widely consumed during the year ...

2.1 Client profile and test use by disease

Biological tests throughout life

In December ****, Medicare published Benchmarks - Issue **, which conducts a focus on the medical biology sector in ****. According to this issue, in ****, a medical biology test was prescribed for nearly ** million people, or **% of the population.

Distribution of persons having had a medical biology analysis prescription by ...

2.2 The main prescribers of biological analyses

Benchmarks - Issue ** (***) also presents **** data for the most active private prescribers of medical biology procedures.

Source: ****

General practitioners are therefore the largest prescribers (***). Gynecologists, cardiologists, and anesthesiologists come next. It can be stated that the majority of procedures prescribed by general practitioners are low-cost procedures: in fact, they prescribe */* of ...

2.3 The star acts of the demand: amount and volume

The most reimbursed procedures in ****

The I+C branch report reveals the ** most reimbursed medical biology procedures in ****.

Source: ****

The top procedures in the ranking changes very little. The most reimbursed examinations are mainly Covid-** tests (***) and general check-ups such as haemograms and ionograms, which are blood tests.

For haemograms (***). In ...

3.1 Local sampling sites: a constant territorial network

The profession in the region includes all the local sampling sites and the laboratories that manage these sites. The sites are registered in the Insee nomenclature under the following NAF code, **.**B: Medical analysis laboratories .

The ACOSS database of the national URSSAF network allows us to obtain the evolution of the ...

3.2 Laboratories: mergers and rationalization of the sector, key players

Number of laboratories

The I+C industry report shows this decrease in the number of laboratories with at least one employee.

change in the number of laboratories (***) employing at least one employee France, **** - ****, in units Source: ****

Over the past ** years, the profession has restructured. Faced with the challenges of cost ...

3.3 Financing of medical biology laboratories

Overview and ****-**** changes in the financing of the CSBM for analysis laboratories

The financing of medical laboratories is provided by various actors: social security, complementary organizations and households. The table below shows the breakdown of the financing of the CSBM for analysis laboratories according to the various public and private ...

3.4 Salary structure

Gender of the workforce

The activity report of the sector conducted by the I+C in ****, allows us to approach the panorama of the number of employees in the sector in ****.

Breakdown of analysis laboratory employees by gender France, ****, in % Source: ****

The activity therefore employs a large majority of women. This ...

3.5 Business expenses: payroll and training

The wage bill

*.* billion in ****, i.e. **% of the profession's turnover. The proportion of laboratories with a profit-sharing agreement in **** is **% and **% of profit-sharing agreements have resulted in a payment.

Training expenses

The system that allows professionals in the sector to train their employees is the training plan. In ****, the ...

4.1 Breakdown of medical biology expenditure by pathology: a range of diagnostics

Benchmarks - Issue ** (***) presents medical biology expenditures by pathology

Breakdown of medical biology expenditures by pathology France, ****, in * or analgesic or anti-inflammatory treatment ** : with or without pathologies, treatments or maternity ***: chronic respiratory diseases (***). Source: ****

Nearly **% of laboratory spending is fairly generalist spending that is not related to a specific pathology. These ...

4.2 Evolution of the CSBM price index for medical analysis laboratories

The **** edition of the results of the health accounts (***) reports the evolution of the price index in the consumption of care and medical goods for analysis laboratories.

annual change in the CSBM price index for analysis laboratories France, ****-****, index *** in **** and % Source: ****

This index has therefore been falling steadily for ...

4.3 The two main types of laboratories

Two types of laboratories can be distinguished on the market:

Routine biology laboratories

These are the non-specialized laboratories that are the most present on the territory. Their role is to respond to a standard demand for medical analysis. These laboratories are often grouped around technical platforms. A place that gathers equipment ...