A continuing medicine shortage has highlighted France’s dependence on China and India for basic chemicals.
In particular, paracetamol and the common penicillin antibiotic amoxicillin, especially in child doses, are becoming increasingly hard to obtain in pharmacies.
It comes as the Senate is to launch an enquiry into the reasons for the shortages, which also affect many other less well-known drugs.
Two months to replenish amoxicillin stocks
According to the French magazine Marianne, the current ‘fiasco’ is largely due to the fact pharma labs have over the last 30 years delocalised production of established drugs so they can concentrate on new ‘innovative’ - and more lucrative – products.
Experts at the ANSM drugs safety agency have said they hoped the amoxicillin shortage was over shortly.
However, Health Minister François Braun said that while paracetamol supplies should return “very soon”, it could take two months to replenish amoxicillin stocks.
Covid disrupted import of paracetamol molecule from China
Much of the paracetamol tablets and syrups sold in Europe are produced in France, especially at the UPSA Dafalgan and Efferalgan factory at Agen in Lot-et-Garonne, and at Sanofi’s factory at Lisieux, Normandy.
The latter is one of the most productive drug factories in the world and usually makes more than a million boxes of the paracetamol brand Doliprane a day.
Both companies rely on basic chemicals which, since 2008, have only been made in countries with low labour costs, including China and India.
Supplies of the paracetamol molecule from China have been disrupted since the start of the pandemic because of increased demand for treating the symptoms of the disease.
Even so, Sanofi announced in January a record year for Doliprane production in 2022: 424 million boxes were made.
Shortages made worse by outbreak of bronchitis in children
The situation in France was aggravated by an outbreak of childhood bronchitis, which saw many children admitted to hospital with breathing issues and others at home prescribed paracetamol and amoxicillin.
French doctors prescribe paracetamol rather than aspirin, which has similar effects, because of worries about stomach bleeding from aspirin.
Amoxicillin used in France is mainly made in eastern Europe.
It is used against bacterial infections of various kinds and is often prescribed here for children when there is a risk of bronchitis turning into pneumonia. For small children, it is often given as a syrup.
To help, the government said pharmacies could make and sell préparations magistrales, meaning they can crush adult-strength tablets and dose the powder into syrups at strengths appropriate for children.
Production delayed at new chemical factory in France
A project by French company Seqens, in which American fund SK Capital Partners is the largest shareholder, to open a chemical factory for paracetamol ingredients in France was launched even before the Covid crisis.
It was given priority during the crisis, including government grants.
Production at the company’s new €100million factory at its site in Roussillon (Isère) has been delayed and is not likely to begin until 2026.
Drug company profits squeezed by social security system
France’s social security system has also been accused of contributing to shortages.
For years, the amount paid to drug companies when doctors prescribe their products has been squeezed to the point where it is more profitable to sell them in other European countries, such as Greece, than in France.
Faced with the shortages, the government issued decrees banning the export of paracetamol until the situation eases.
The sale of paracetamol over the internet has also been suspended to stop profiteering.