Some antibiotics may be sold pill by pill due to shortages in France

Pharmacies may be obliged to sell some antibiotics ‘pill by pill’ - and not in a pack - to help fight drug shortages in France over the winter period, a government source has claimed.

It would happen when a certain drug is classed as in short supply, such as Clamoxyl.

The aim is to reduce the amount of unused antibiotics that rest dormant in people’s homes, after they collect their prescribed medicine but do not follow the full course of treatment.

It is one of a number of plans which may be activated to protect dwindling medical supplies.

Reactions from pharmacists have been mixed – although an ‘individual pill’ method is already in practice in some outlets, it was dubbed “a real hassle” by the president of the union des syndicats de pharmaciens d'officine.

This is because it can make it difficult for pharmacists to accurately trace who has been given which medicines, as well as how they can be stored.

Claims it will make life difficult for patients and pharmacists

The information was released via an unnamed government source, although the person stressed it would not be implemented on a widespread basis.

“There will be no rationing. The idea is to make it compulsory to distribute individual medicines when there's tension. But not all [medicines], just certain antibiotics,” the source told the AFP press agency.

“There is also an interest in combating antibiotic resistance in this way,” the source added, with France having one of the highest levels of antibiotic usage in Europe.

For patients on a course of antibiotics in short supply, they will have to visit their pharmacy every day to receive a tablet instead of making a single visit to collect their pills in a pack all at once.

The system is not practical for distributors either.

“We order [the medicines] from a laboratory in Marseille, which prepares capsules that we distribute individually, but it's much more expensive,” said one pharmacist.

On top of the increased cost, the difficulty in stocking the medicine after partially opening them is also a cause for concern.

“Opening [each individual] tablet is not the right answer. In terms of batch number traceability, it's a real hassle,” said the president of the pharmacists’ union.

Medicines can be misplaced or lost this way, and it is much more difficult to know which medicines have been assigned to each patient – as well as making sure the pharmacy has enough stock to allow people to finish their prescribed course of treatment.

“There is no consensus on single-dose dispensing from an industrial point of view", said the pharmaceutical laboratories’ lobby regarding the potential changes.

Read more: Two-thirds of French pharmacies understaffed

One of many changes to fight shortage

The change is only one of a number of measures the government is expected to introduce to fight antibiotic shortages over the upcoming winter period.

Pharmacies will be able to dispense certain antibiotics without a doctor’s prescription, provided the patient has undergone specified tests beforehand, announced Health Minister Aurélien Rousseau recently.

This will prevent a backlog in prescriptions coming from doctors, as well as stop the overprescription of certain drugs.

The government also has improvements to the pharmaceutical supply chain in their sights.

In the event of a shortage of a drug, all facilities able to produce it – including hospitals – will be authorised to make their own batches of the medication.

Whilst this will not prevent long-term shortages, it will be enough to tide pharmacies over when the danger is most critical.

Levers will also become available if a manufacturer tries to pull a drug deemed as a necessity off the market.

If an alternative is not found, the state will be able to force the medication to be sold by the company free of charge for two years to public bodies such as hospitals.

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