Reports of medicine shortages in France have risen sixfold since 2016, with over a hundred different drugs affected.
Some of the most commonly reported shortages concern medicines used to treat high blood pressure, cardiovascular conditions and neurological issues.
Last year, one in four people reported difficulties in obtaining the medicines they needed because of their scarcity.
Earlier this month it was announced that pharmaceutical laboratories would from now on have to stock at least two months’ worth of “products of major therapeutic interest” to avoid shortages.
We look at the drugs that are most frequently reported to be in short supply, and the potential reasons behind this.
Which medicines are affected?
Medicine shortages have risen year on year since 2016, when there were 405 reports of a laboratory warning that they may run out of stock. In 2020, this figure had risen to 2,446, according to France’s medicines agency, l'Agence nationale de sécurité du médicament et des produits de santé (ANSM).
The spread of Covid-19 also caused a shortage of the muscle relaxant curare, which was widely used to treat intensive care patients.
ANSM reports also show that blood pressure medications irbesartan and ramipril, as well as other medicines concerning the cardiovascular and nervous systems are often subject to shortages.
Risperidone, which is used to treat schizophrenia, and lansoprazole, which eases stomach inflammation and ulcers, are also among the most commonly reported shortages.
When certain medications are in short supply, healthcare workers are left without an alternative treatment.
A November 2020 study* carried out by consumer group UFC-Que Choisir indicated that in 18% of cases, “laboratories do not offer any substitute, leaving patients in a terrible impasse.”
For other medications, manufacturers might suggest a “mediocre” alternative that may bring with it dangerous side effects, the group said
*The UFC-Que Choisir study concerned the 140 medicines reported to be out of stock or in short supply by the ANSM in July 2020.
What has caused the problem?
This rise in reports of shortages is in part due to the introduction of a 2016 law which lowered the threshold upon which laboratories were required to report a lack of supply to the ANSM.
The 2020 Loi de financement de la sécurité sociale (Law on the funding of social security) also reinforced the sanctions that laboratories might face if they failed to declare a potential stock shortage as far in advance as possible.
Figures also indicate that medicine supply was impacted significantly by the Covid-19 pandemic, with 700 shortages reported in March and April 2020 alone, when countries were closing their borders to combat the virus’ spread.
At that time, 80-85% of France’s medicines and active medical ingredients were produced in China, according to Economy and Finance Minister Bruno Le Maire, who described this situation as “irresponsible and unreasonable.”
Even before the pandemic began, this dependence had posed issues. In 2017, to reduce its emissions, China limited the electricity supply of some industrial zones, which housed several pharmaceutical factories. This led to a global shortage of the antibiotic amoxicillin and clavulanic acid.
Several experts in the pharmaceutical field have also suggested that the short supply of many cheap, commonly used drugs may be down to the economic strategy of the manufacturing company.
Philippe Lamoureux, director general of pharmaceutical companies association LEEM told Le Monde that “when medicines enter the public domain and the market is filled with competitors, their price falls very rapidly.
“Sometimes the price falls below the cost of production, and so the medicine is no longer produced.”
An ANSM study on the 3,530 shortage reports made between 2012 and 2018 showed that 63.4% of the medicines in question had first been made available over 10 years before, meaning that they were no longer profitable for the manufacturers.
If production stops and supply is reduced, demand – and therefore profitability – will increase.
Decisions to stop manufacturing certain medicines have direct effects on patients. On September 7, Franceinfo reported on the story of ‘Marc’, who was forced to have his bladder removed following repeated shortages of the medicines he needed for his cancer treatment.