Drug shortages: between quotas and political communication

Paris, Thursday, 8 December 2022 – Tensions are rising over drug supplies, but the government is trying to minimize the situation as much as possible.

On the one hand, there are statements on Twitter by public figures, such as the journalist Apolline de Malherbe, based on personal experiences and possibly biased. On the other hand, there are statements by the government, which no doubt tries to minimize the gravity of the situation in order to avoid a political crisis. The extent of the deficiency between the two, or rather, is difficult to determine “supply voltage” to use the official term that currently applies to many drugs including paracetamol and amoxicillin.

Pediatric Dolipran: the end of direct laboratory delivery

Supply difficulties for French pharmacies for paracetamol started in the spring, but worsened in recent weeks with the return of winter epidemics (except for Covid), which appeared on a larger scale than in previous years. Thus, the Sanofi laboratory, the manufacturer of Doliprane, reports a 47% increase in delivery requests from pharmacies for its pediatric formulation in 2022 compared to 2021. On the other hand, the production did not decrease, the UPSA laboratory, the manufacturer of Efferalgan, even increased it by 20% for adult products and 50% for children’s products.

Dolipran is a drinkable form that is also suitable for children. To deal with the onset of the shortage, various players in the sector (pharmacists’ associations, wholesale distributors, ANSM) took a rare decision on Tuesday, deciding that pharmacies cannot buy supplies directly from Sanofi subsidiary Opella Healthcare’s laboratory. , but only to wholesale distributors. The latter will have to supply only their core customers to prevent pharmacies from turning to multiple suppliers.

Amoxicillin: supply tension until March

The purpose of this measure is to ensure a fair distribution of children’s Dolipran stocks among pharmacies, whereas the existing quota measures (700 boxes per day per pharmacy and no more than two boxes per patient) are insufficient. But Philippe Besset, president of the Federation of Community Pharmacists’ Unions (FSPF), warns that reaching out to wholesale distributors is not a miracle solution, with evidence that amoxicillin is also in short supply. “It is now almost exclusively distributed through wholesale distributors”.

According to the National Agency for the Safety of Medicines (ANSM), supply tensions on the amoxicillin front began in mid-October. “This amoxicillin shortage affects all of Europe as well as other international markets.” The narcotic gendarmerie points out that this tension may continue until next March. Here, too, the delivery of this antibiotic, widely used in pediatrics, is subject to quotas for both health facilities and pharmacies, and doctors are encouraged to prescribe it in small quantities.

There is no shortage of Dolipran…according to the government

These supply challenges are heavily used by the opposition to decry the fragmentation of our healthcare system. Therefore, the government is trying to somehow calm the situation. Speaking before the Senate on November 9, Health Minister François Browne was optimistic, assuring wholesale distributors that stockpiling obligations would avoid shortages of amoxicillin. This Wednesday, Industry Minister Roland Lescure sought to reassure the French by explaining to senators. “We are not facing a shortage of Dolipran”claims that “The situation is improving” and to encourage parents seeking paracetamol for their children “a few pharmacies”.

Optimistic members of the government, and sometimes a little too much, can distort reality. Government spokesman Olivier Veran explained this to France 2 on Tuesday “As promised by the President of the Republic, we are re-producing paracetamol factories in France, Isere”. But unfortunately for the credibility of the former health minister and for French people in need of the drug, the paracetamol factory in Roussillon in Isère will not open until 2023 and will not start its first deliveries until 2025.
“supply voltage” settled by then.

Nicholas Barbert

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