Mapping Stakeholder Alignment for Deprescribing Policy in France: Insights from a Policy Delphi Approach

Abstract Background With growing efforts aimed at optimizing health care services by reducing “low value care”, medical deprescribing represents a critical policy challenge at the intersection of clinical quality, fiscal sustainability, and environmental stewardship. Despite growing evidence of its benefits, France lacks a comprehensive national framework for systematic medication review and deprescribing implementation. Objective To identify areas of consensus and divergence among key French stakeholders using an adapted Policy Delphi approach to inform national deprescribing policy development. Methods An exploratory survey was conducted among stakeholders across five groups (healthcare professionals, patients, academia, policymakers, and the pharmaceutical industry). Consensus levels were assessed using graded Likert scales and analysed across policy domains, including knowledge and training, collaboration, resources, policy support, and sustainability opportunities. Results High consensus emerged around knowledge gaps, the need for interprofessional collaboration, and clinical benefits of deprescribing. Moderate consensus existed regarding resource constraints and environmental sustainability. Divergence was observed between professionals/academia and policymakers/industry regarding financial incentives and regulatory readiness. A policy Delphi heatmap revealed specific alignment patterns that could serve as policy entry points. Conclusions Multi-stakeholder consensus mapping provides an innovative governance tool for identifying actionable policy opportunities and contributes to recent tools aimed at reducing low-value care. High-consensus domains, including training, patient safety, and sustainability, offer immediate entry points for coalition-building. On the contrary, areas of divergence require structured dialogue and iterative policy learning among France’s fragmented governance structures to translate stakeholder alignment into systematic deprescribing implementation.