As of November 18, at least 277 medicines are currently facing supply shortages in France. Between 2016 and 2021, reports of risks of shortages or confirmed stock shortages were multiplied by 5.
go where to a shortage of amoxicillin? The National Agency for the Safety of Medicines (ANSM) confirmed on Friday that the antibiotic, mainly used to treat angina and otitis in children, “is subject to severe supply tensions in France (especially the drinkable forms) , which could last until March 2023”.
The agency points out that one of the main 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 emergence of difficulties in industrial production lines “which did not recover their production capacity before the Covid-19 pandemic”.
This risk of shortage fits into a broader context, in which the authorities have already been forced in recent months to tighten the use of some medicines. The most emblematic case, paracetamol, an omnipresent painkiller in the bathrooms. Authorities advised pharmacists not to sell more than two boxes per patient, despite assurances from manufacturers that there would be no shortage.
The ANSM is updated daily, a list of medicines of great therapeutic interest (MITM) who are experiencing supply difficulties and for which there are currently no or too few therapeutic alternatives available on the French market.
These are “drugs or drug classes for which 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 respect to the severity or evolutionary potential of the disease “.
The complete list of the treatments involved can be seen in the table below.
Concerns about shortages go back much further than in recent months, although the situation may have worsened in the context of inflation and the escalation of geopolitical tensions with the war in Ukraine.
“Since 2008, situations of shortage of stocks and supply tensions have been proceeding at a worrying rate in France, but also in the United States and in other countries of the world”, Leem, the French lobby of the sector, already noted in 2019.
During the Covid-19 pandemic, in 2020, a maximum of 2,446 reports of breakage or risk of breakage were made to the ANSM. A year later, the agency received 2,160 reports, five times more than in 2016, as shown in our chart below.
However, the ASNM specifies that since 2019, the agency has asked manufacturers to declare all risks of breakage as upstream as possible, so that it can better anticipate measures to reduce the impact of these likely breakages.
“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. Medicines and treatments concerning the cardiovascular system are at the forefront, representing 26.70% of reports to the ANSM.
These are 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.
As for amoxicillin, the authorities have therefore adopted a series of emergency measures, including rationing which limits the quantity that each pharmacy can order. They have also urged doctors and patients to use these antibiotics only when necessary: for example, they have no interest against bronchiolitis, in the midst of a bronchiolitis epidemic.
But these measures announced on Friday are not convincing all observers. Such speeches “do not attack the structural causes”, estimates the Observatory on Transparency in Drug Policies in a statement, an organization marked on the left.
He deplores a lack of responsiveness by the authorities in the face of a “foreseeable” situation requiring a massive transfer of drug production to France, believing that the disruption of this production in different countries contributes to supply problems.
For amoxicillin, while asking laboratories to increase their production capacity, the Medicines Agency also indicated that “investigations are underway to identify the routes for importing these antibiotics from abroad”.
