If pediatric paracetamol and amoxicillin supply disruptions persist in pharmacies in January, these are not the only drugs to worry health professionals. In fact, all therapeutic classes are affected, a phenomenon that has been getting worse for fifteen years. At the top of this list: anti-infectives, drugs for the nervous system (including antiepileptics, antiparkinsonians) and those for the cardiovascular system (thrombolytics used in the event of a stroke, etc.) are those which suffer the most ruptures of supply, i.e. an unavailability of more than 72 hours for patients.
Actilyse, Metalyse, injectable Aspégic… Isabelle Maachi-Guillot, head of the health products division at the Bordeaux University Hospital, is inexhaustible when it comes to listing the products that she struggles to obtain. “Actilyse and Metalyse are used to treat strokes and myocardial infarction. This is very worrying, because the ruptures have been going on for months”, explains the pharmacist. It is the same for certain medical devices used daily in digestive surgery. “We spend a lot of time managing these ruptures, but also internal and external discontent”observe Mme Maachi-Guillot. On the one hand, doctors unhappy to have to change their treatment strategy in the absence of the adequate drug; on the other, patients who struggle to find the prescribed products once they leave the hospital.
“Managing breakups has become a routineagrees Pierrick Bedouch, head of the pharmacy department at the Grenoble University Hospital. For the moment, this does not prevent us from treating the sick, but it takes us a lot of time and energy to find solutions. » Of the 2,500 drugs used in his establishment, more than 300 are out of stock. It is then a question of juggling with other solutions: favoring injectable forms if the capsules are missing, carrying out dilutions or even preparing formulations oneself, with the authorization problems that this poses.
“It is a public health phenomenon that is getting worse and worse and for which we do not see any immediate solutions”, regrets Pierrick Bedouch. In 2008, 43 medicinal products of major therapeutic interest were reported to be ruptured or at risk of rupture by manufacturers; they were 871 in 2018 and more than 3,500 in 2022.
The Covid-19 pandemic and the war in Ukraine accentuated an already upward trend, slowing down international trade. The vast majority of active ingredients are indeed developed in India and, above all, in China, while the aluminum, cardboard and glass packaging are largely produced in Ukraine.
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