Pénurie de médicaments : Des solutions pour y faire face

“Des solutions existent face au manque actuel”

President of the Union of Pharmacists of Var, Patrick Magnetto juggles this week between two vaccinations and the continuous flow to his pharmacy in Fayence to take the time to analyze a phenomenon that is not new. Also vice-president of the Regional Union of Health Professionals (URPS), he has joined the working group of the White Plan to find solutions, especially for our seasonal territories.

After the Minister of Health’s remarks, can we talk about a shortage of medicines?

Shortages are national. The particularity of Var, for example, is that with the strong seasonality, we have already experienced this shortage last summer.

Which medicines are most affected at the moment?

Let’s talk about molecules under stress like amoxicillin, amoxicillin/clavulanic acid, cortisone… The shortage has been going on since last winter, but with the return of cold weather and its pathologies, new peaks are to be expected. With global shortages, supplies are uncertain. One day it’s flecainide for heart problems, another day it’s permixon for the prostate or the medicine for dental infections, etc. As the song says, “it goes away and it comes back”! When we lose the molecule, we switch to an equivalent that triggers a new predictable shortage.

What is the atmosphere in the pharmacies regarding the unsatisfied expectations of the “patients”?

This creates tensions, especially when it comes to long-term treatment. People can anticipate their renewal but we are constrained by legislation to replenish three weeks before the end of the initial treatment.

How to find a vital medicine urgently if your local pharmacist is out of stock?

Several solutions. We try to find an equivalent if it exists. We work with our wholesale distributors as is the case for the injectable antidiabetic Trulicity. We contact other pharmacies to guide people. Depending on the medicines, we can also provide magistral preparations with authorized partner pharmacies within 24 hours. This is possible with amoxicillin syrup for children. In any case, manufacturing laboratories keep reserves for urgent cases.

What are the causes of these shortages?

They are multiple. We are dependent on a chemical molecule synthesized most of the time abroad (China, India). Then, these countries with huge populations are becoming more and more consumers of their own production. Finally, international tensions destabilize the circuits, including packaging (blister, aluminum).

How can all this be resolved?

In addition to the above, we must talk about the selling price of medicines which is one of the lowest in France. However, a laboratory is a business, so it will focus on more profitable European markets: take Italy, it did not experience a shortage of amoxicillin or paracetamol… To balance it out and have a price consistent with Europe, the French State in agreement with the laboratories has just concluded an agreement to increase the price of amoxicillin by 10%.

Selling per unit: a solution?

It is a band-aid, a temporary and insufficient solution. In the region, the experience has not been conclusive. It would be necessary to rethink the entire industrial and distribution chain, which implies new costs… Maybe it would work in a real ecological economy…

And production decentralization?

Indeed, there would need to be a relocation of manufacturing in France. The first European paracetamol factory is scheduled to be established in Toulouse in 2024. It is also necessary to consider a revaluation of prices in line with European prices. This is an obvious political choice as it will affect the CPAM’s budget.