What is the hold-up in dealing with medicine shortages in France?

A government plan to ease medicine shortages in France has been delayed, even as stock tensions and shortages continue and worsen.

Shortages in the past few years have affected pharmaceutical manufacturers, wholesalers and distributors, health professionals, and patients.

Read our previous article: Supply issues for medicines in France: Thousands of drugs affected

In April 2023, Former Health Minister François Braun announced “a big plan” that we are putting in place to tackle the medicine shortages”. This included intentions to:

• Create a new, precise list of medicines that people in France cannot do without

• Identify all production points in France and the active ingredient produced

• Ensure that essential medicines are always available

• Repatriate the production of active ingredients to France and the European Union

Health minister changes

The delay with bringing in this proposed plan has partly been explained by the change in health minister.

Mr Braun had been due to make a presentation to this effect to the industry on July 20, but instead, the cabinet reshuffle saw him depart the office on the same day.

Six months later, the newly-appointed minister Aurélien Rousseau had been due to make a presentation on the issue on December 19, but it was again cancelled. No update has since been posted.

‘Lack of a roadmap’

This “lack of a roadmap” about how to “prevent these shortages” means that it is “difficult to make progress on a number of aspects of this issue”, said Thomas Borel, scientific director at LEEM, the pharmaceutical industry union.

The LEEM has proposed the setting up of a platform that would provide each link in the medicines chain (laboratories, wholesalers, pharmacists, doctors) with real-time information on available stocks.

Some measures in place

The government has already implemented some of its proposed measures, however.

This includes providing a list of 450 medicines that are considered essential, and the identification of 147 that are now a “priority for relocation” of their manufacture in a bid to avoid shortages in the supply chain.

Bringing the production of priority medicines back to French soil was a key election pledge of President Emmanuel Macron, who announced a desire to have ‘medical sovereignty’ by 2030.

Pharmacists are also now authorised to dispense a precise number of tablets or treatments, and split a box, rather than giving patients the entire box (or equivalent).

Medicine safety agency l’Agence nationale de sécurité du médicament et des produits de santé (ANSM) has also aimed to put a ‘winter plan’ in place, to avoid seasonal shortages on the same scale as those seen over the winter of 2022-23.

Then, popular medications including painkiller paracetamol and antibiotic amoxicillin were in very short supply due to a lack of provision by laboratories.

Read more: Shortages of 4,000 medicines in France; what risk for this winter?

Read more: Alert raised over shortages of antibiotics in pharmacies in France

Some shortages continuing

Paracetamol is no longer in short supply, the ANSM said, but stocks of paediatric amoxicillin are still limited, said director general Christelle Ratignier-Carbonneil.

“The tensions are linked to disruption of the distribution system,” she said. “Manufacturers have the quantities they need, but because of last year's shortage, some of their actions led to this chaotic situation where products are [still] unavailable to patients.”

‘Back on track’?

Yet, the ANSM said that a new “charter of commitment” has now been signed by laboratories, wholesalers and pharmacists to help the situation get “back on track”.

“The situation is improving,” said Ms Ratignier-Carbonneil. “Manufacturers have been asked firmly to release stocks. Dispensaries now have a few days' visibility, and wholesalers have been restocked with amoxicillin.

“We're on the right track, but we need to be very careful and continue our efforts,” she said.

The ANSM has also been granted greater ‘watchdog’ powers, particularly when it comes to levying financial penalties to manufacturers who do not keep to their obligations, said Catherine Simonin, manager at France Assos Santé, the patient and health system user rights union.

She said that this was “good news”.

The association is also continuing to pressure the government to get its plan up and running, and to “take strong measures” to ease the shortages, she added.

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