2023-07-06 17:19:00
After more than five months of investigation and 54 hearings of health professionals, patient associations or representatives of the sector, the Senate committee delivers this July 6 a severe report on the “bankruptcy” of the drug policy in France. The senators also present 36 specific recommendations to end the shortages.
The senators first note a “clear worsening” of the situation since 2018. France has thus gone from 700 reports of stockouts in 2018 to more than 3,700 last winter. This figure, unprecedented in its magnitude, is the result of a lack of anticipation by both the public authorities and the industrialists of the triple winter epidemic of Covid, influenza and bronchiolitis.
READ ALSOAttacks on pharmacists up sharply in 2022 “More than 70% of the drugs affected by shortages or tensions are old drugs whose profitability has declined over the years. This is the case of so-called daily use drugs, but also of certain anti-cancer drugs, ”underlines Sonia de La Provôté, senator from Calvados (Centrist Union). For the president of the commission, as for the other rapporteurs, drug shortages are a “form of global health scandal”.
Increase prices under conditions
For a long time, the rise in drug prices has been presented by manufacturers as a prerequisite for building up stocks on a competitive international market. The senators are not saying no, but they want guarantees. “Despite their obligation to ensure market supply, laboratories are losing interest in mature products in favor of innovative drugs, the prices of which are experiencing a frightening increase”, underlines Sonia de La Provôté.
The report proposes to make future price increases “a tool for securing supply”. In other words, if the price of certain mature drugs were to increase, manufacturers would have a real obligation to stock up and prevent all forms of shortages.
READ ALSOShortage of antiepileptics: Giulia Foïs launches the alertThe commission’s report also calls for a coordinated European response. Indeed, when a pharmaceutical product is missing in a country of the Union, it is not always easy to transfer available stocks to neighboring countries. To promote the redeployment of medicines within the Union, the report recommends “harmonizing national packaging and labeling rules”. It also proposes to dematerialize the leaflets for certain essential drugs. For the moment, the State’s main response consists of “quotas” certain medicines in tension, but “the reality of quotas is that it is a nice word for partial shortages”, recalls Sonia de La Provôté.
The communication of François Braun “erratic”
The report also returns to the list of some 450 so-called essential drugs unveiled by François Braun, the Minister of Health, in June. This list, expected for years, was to identify in particular the products for which it is imperative to stock up, and those whose production should be relocated to France. If the senators do not fail to recognize the potential interest of such a list, they underline that “its method of elaboration has aroused the strongest criticism from certain learned societies” and that the “Haute Autorité de santé n was not requested”.
READ ALSOList of expert doctors: the survey that guides youThe report especially singles out the Minister of Health for his contradictory statements. On June 13, François Braun declared to the Parisian : “Manufacturers will have to have four months of stocks for these essential drugs. Maybe even more for some. “Two days later, before the commission of inquiry, he explains:” There is neither decision, nor choice, nor will on my part to report this obligation of stocks of four months to the whole of the list. “Difficult to follow him. For Sonia de La Provôté, the communication from the Ministry of Health is to say the least “erratic” on the subject.
In addition, the rapporteur wishes to alert to the fact that “French manufacturers are considering in the coming months and years to abandon the production of nearly 700 drugs, including drugs of major therapeutic interest”, therefore potentially present in the list of the minister.
State credit: require counterparties
Among the key proposals of the report, one of them points to the need to require compensation in exchange for the many tax incentives enjoyed by laboratories in France. The pharmaceutical sector is for example the second beneficiary of the research tax credit (10% of the total amount, ie 710 million euros). The effort, considered “colossal” by the senators, “did not prevent relocations, nor did it succeed in anchoring the production of innovative drugs in France”. The investigation conducted by the commission with the Directorate General of Public Finances even revealed “highly questionable” CIR optimization practices.
READ ALSOHealth – The blacklist of drugsThe Senate report therefore recommends “redirecting public aid towards the production in France of essential drugs rather than towards innovation alone” and “systematizing the use of conditionalities (sustainability of industrial presence, location of intellectual property, supply of the market French) “.
Finally, the senators denounce the weak impact of the projects financed by the “France 2030” recovery plan, widely presented by the government as a response to shortages. Out of 106 projects included in this plan, “only 18 concerned a real relocation” and “5 concerned a strategic drug”, analyze the elected officials.
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