Why the drug shortage is expected to last

Shortage of painkillers, running out of antibiotics, pharmacies starting to produce them: drug tensions can last a long time and actually involve many treatments. Focus on global phenomena.

What drugs are affected?

Amoxicillin, an antibiotic widely prescribed for children, has been affected by scarcity to the point that the National Drug Safety Administration (ANSM) recently allowed certain pharmacies to manufacture it, while laboratories ramped up production.

Paracetamol is also under strain, especially in its pediatric form. But if these two drugs hit the headlines, all drug classes are affected by stock shortages or supply tensions, according to the ANSM, including, for example, corticosteroids. Three types of drugs known as “main therapeutic interest” are more specifically exposed: anti-infectives, drugs for the nervous system (antiparkinsonians, antiepileptics) and for the cardiovascular system.

Is this phenomenon recent?

Deficiency issues became especially visible with the pandemic, with certain essential molecules, such as muscle relaxants, running out of hospitals. However, the phenomenon has been going on for years, a result of decades of globalization, which has centralized the production of active ingredients in several Asian countries, China and India taking the lead.

However, the problem is getting worse. In 2021, ANSM received 2,160 reports of out-of-stock and risk of stock-out, compared to 405 in 2016, 1,504 in 2019 (and nearly 2,500 in 2020, at the heart of the pandemic).

Yann Mazens, who follows the subject in the France Assos Santé user network, specifically cites the case of intravesical BCG, which is used in bladder tumors. “This is a drug that went into shortage in 2016-2017, and these tensions are returning”, he laments: “Behind the backdrop of this subject, there is a loss of opportunity for patients”, he explains, citing bladder ablations that are performed “with no drug available “.

Is this a common problem?

The tension is far from limited to France. The United States, Canada, Australia are also sounding the alarm over amoxicillin shortages. Germany is experiencing shortages of various medicines, including fever syrup and painkillers. The UK Department of Health also acknowledged in mid-December a shortage of certain antibiotics used to treat streptococcal A infections.

Even the main producing countries of active ingredients are concerned. China thus requested the production of certain pharmaceutical companies in late December, at a time when millions of Chinese were struggling to obtain basic medicines to treat themselves in the face of an unprecedented wave of Covid-19. Specialists in this sector point to an economic model, which means that large laboratories gradually withdraw from old molecules, which are less profitable economically than new products. In June 2020, a senator’s report on the matter was published in France: thus showing that the stockout was unrelated to new, more expensive drugs.

What is the solution?

French health authorities have implemented several measures depending on the drug in tension. This primarily involves identifying specialties that can replace failed pharmaceutical specialties, or prohibiting the export of certain specialties by distributors.

From 2022, French pharmaceutical companies will be subject to tougher sanctions than before if they do not take adequate action against certain treatment deficiencies. It must be said that the number of sanctions is rare: none in 2021, three in 2022, recalls France Assos Santé. More broadly, specialists in the sector are begging for the relocation of certain molecules to Europe… provided a successful economic model is found.

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