Between 2016 and 2017, there was a 30% increase in drug stockouts in France. A real shortage of vital drugs which also affects cancer drugs, antibiotics, vaccines and anti-Parkinson drugs. A ludicrous situation.
In a developed country like France, 530 drug stock-outs were reported in 2017, many of which relate to drugs “of major therapeutic interest”. This is a 30% increase in drug shortages compared to 2016. A group of patients, suffering from Parkinson’s disease and who can no longer treat themselves, denounce this ludicrous situation.
We are therefore not talking about new drugs or minor drugs, we are talking here about old products whose therapeutic use is considered to have a major contribution and whose consumption we know in advance, almost from day to day, and mainly dispensed in hospitals or sold in pharmacies.
For anti-parkinsonians, the association France Parkinson alerts the public authorities to stock shortages of Sinemet® which prevent the treatment of 60% of the 200,000 patients. For cancer drugs, it’s the same thing for 5FU or vincristine, 2 major products that are part of the composition of many chemotherapeutic combinations. For antibiotics, it is no less than amoxicillin, a commonly prescribed antibiotic, which is regularly missing. Not to mention vaccines…
Numerous and multifactorial causes of ruptures
According to the Order of Pharmacists, the causes of these ruptures are both “numerous and multifactorial”. Among the main ones is insufficient production capacity. Most generic drugs are no longer manufactured in France: 70% of the molecules used to manufacture most treatments are manufactured in the United States or in Asia, on a limited number of sites. The slightest problem in a factory spells disaster.
For some products, it is the delay in production or the inability to produce in one of the few factories that remain due to a lack of the molecules necessary for the composition of the medicine: these causes affect all the factories in the world that produce different medicines at from an essential molecule. These causes are responsible for 17% of ruptures according to the ANSM).
The phenomenon is further aggravated by the desire to restrict inventories which cost laboratories money and the resulting “just in time” principle: to avoid inventory-related costs, laboratories reduce them as much as possible, and the stock is in the trucks or the boats. At the slightest weather or political problem, it’s a guaranteed break.
The Order of Pharmacists also cites the globalization of demand and the free movement of goods: when the quantities of drugs are too tight in relation to demand, laboratories prefer to sell to the countries that pay the best (the highest bidders) and this is most often not the case in France.
Measures to improve surveillance
To deal with this insane situation, the Senate created an information mission and it recently made proposals. The main ones aim to relaunch local pharmaceutical production, in France or in Europe, to establish a public program for the production and distribution of a few essential drugs, to make manufacturers responsible, to facilitate the professional exercise of distributors and to develop cooperation European. But all this comes up against the imperative of costs…
The United States, faced with the same problem, reacted and implemented solutions that seem to work (local manufacturing, securing the distribution of essential products (strategic stocks), price agreements, etc.). The National Academy of Pharmacy is on the job: it is urgent that France, and more broadly the European Union, take the necessary measures for the good of patients who have difficulty in these situations.
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