beyond amoxicillin, many treatments concerned

As of November 18, at least 277 drugs are currently subject to supply difficulties in France. Between 2016 and 2021, reports of risks of shortages or confirmed stock shortages were multiplied by 5.

Are we going to a shortage of amoxicillin? The National Medicines Safety Agency (ANSM) confirmed on Friday that the antibiotic, mainly used to treat angina and otitis in children, “is subject to strong supply tensions in France (especially the forms drinkable), which could last until March 2023”.

The agency specifies that one of the major reasons for these tensions lies in the sharp increase in the consumption of antibiotics – even when their prescription is not necessarily justified. Added to this phenomenon is the appearance of difficulties in industrial production lines “which have not regained their production capacity before the Covid-19 pandemic”.

This risk of shortage is part of a broader context, where the authorities have already been forced in recent months to tighten the use of certain drugs. The most emblematic case, paracetamol, an omnipresent painkiller in bathrooms. The authorities have recommended that pharmacists not sell more than two boxes per patient, despite assurances from manufacturers that there would be no shortages.

The ANSM updates a daily list of medicinal products of major therapeutic interest (MITM) which are experiencing supply difficulties and for which there are currently no or too few therapeutic alternatives available on the market. the French market.

These are “drugs or classes of drugs for which an interruption of treatment is likely to jeopardize the vital prognosis of patients in the short or medium term, or represents a significant loss of opportunity for patients with regard to the seriousness or evolutionary potential of the disease”.

The complete list of the treatments concerned is visible in the table below.

Concerns about shortages go back much further than the past few months, although the situation may have worsened in the context of inflation and the outbreak of geopolitical tensions with the war in Ukraine.

“Since 2008, situations of stock shortages and supply tensions have been progressing in a worrying way in France, but also in the United States and in other countries of the world”, noted already in 2019 Leem, French lobby of the sector. .

During the Covid-19 pandemic, in 2020, a maximum of 2,446 reports of rupture or risk of rupture were made to the ANSM. A year later, the agency received 2,160 reports – five times more than in 2016, as shown in our graph below.

However, the ASNM specifies that since 2019, the agency has asked manufacturers to declare all the risks of rupture as far upstream as possible, in order to be able to better anticipate measures to reduce the impact of these probable ruptures.

“This policy of anticipation has resulted in an increase in the number of reports received”, indicates the National Agency for the Safety of Medicines.

Cardiovascular system, nervous system…

In its activity report for the year 2020, the agency presents the ranking of the most affected therapeutic families. In the first line, drugs and care concerning the cardiovascular system, which represent 26.70% of reports to the ANSM.

This is followed by treatments that focus on the nervous system (25.55%), then anti-infectives for systemic use (11.90%), as shown in our graph below.

With regard to amoxicillin, the authorities have therefore taken a series of emergency measures, including rationing which limits the quantity that each pharmacy can order. They also called on doctors and patients to use these antibiotics only if necessary: ​​for example, they have no interest against bronchiolitis, in the midst of an epidemic thereof.

But these measures announced on Friday do not convince all observers. Such speeches “do not attack the structural causes”, estimated in a press release the Observatory of transparency in the policies of the drug, an organization marked on the left.

She regrets a lack of responsiveness from the authorities in the face of a “foreseeable” situation calls for a massive relocation of the production of drugs in France, believing that the break-up of this production in several countries contributes to supply problems.

For amoxicillin, while asking laboratories to boost their production capacity, the Medicines Agency also indicated that investigations were “in progress to identify avenues for importing these antibiotics from abroad”.

Théophile Magoria with AFP

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