2023-04-20 09:28:00
The Observatory of transparency in drug policies warns of supply tensions for misoprostol used for medical abortions.
Par Johanna Amselem
© ANNA MONEYMAKER / GETTY IMAGES NORTH AMERICA / Getty Images via AFP
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« Ithere is no break. If the Minister of Health wants to be reassuring, many pharmacies are struggling to sell an abortion pill, misoprostol. François Braun concedes the existence of a “tension” but recalls that “access to this abortion pill is possible everywhere” and that, “if we do not find [le misoprostol] in pharmacy […]he is still available at the hospital […], and the centers that practice voluntary termination of pregnancy have boxes available”. Monday, April 17, in a letter addressed to the Minister of Health, the PS vice-president of the Senate, Laurence Rossignol, estimated that the shortage had taken “a further step” and that it “affects[ait] women’s rights “.
According to the Observatory of Transparency in Medicines Policies (OTMeds), misoprostol has been or still is very difficult to find in certain places in France, such as Lille, Versailles, or Issy-les-Moulineaux. “We recently received new testimonials indicating that it is not available either in Occitania or in certain Parisian pharmacies”, recently added Pauline Londeix, co-founder of OTMeds.
What is it regarding ? Misoprostol is an abortion pill that causes the expulsion of the embryo. As part of a medical abortion, it is necessary to take two different pills. Misoprostol should be taken 36 to 48 hours following mifepristone. It must also be used before non-medicated abortions.
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How can this supply tension be explained?
Currently, there are no generics or equivalents to misoprostol. This medicine is under patent, so there is no alternative. “This concentration of production makes the supply chain vulnerable. In the event of an industrial problem, impurities, production lines slow down or stop, and there are no fallback solutions to keep production up to world demand. Local, diversified, at least partly public production is a pragmatic response to this problem”, suggests the Observatory of transparency in drug policies in its point of April 18, 2023.
Quoted by Release, Jérôme Martin, co-founder of the Observatory of transparency in drug policies, also makes a link between the situation of French tension and American threats: “The concentration of production makes production itself a little more vulnerable, as much in the face of to industrial problems than to threats from anti-abortion lobbies. If you have diverse sites, calls for boycotts or threats are possible, but you have more possibilities to resist. There, with only one laboratory producing, we further weaken access to this technique. »
In a press release, the High Council for Equality between Women and Men (HCE) confirms the link with the recent announcement of the suspension of the marketing authorization in the United States of mifepristone (RU 486 ), one of the two components of the abortion pill used for medical abortions. “The American situation poses the threat of a shortage linked to the constitution of stocks by the American States which seek to compensate for a possible stoppage of the production and/or marketing of mifepristone and misoprostol. Another risk: a sharp increase in prices, due to possible production and supply disruptions. »
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What solutions have been implemented?
A situation far from trivial since in France regarding 70% of abortions are medicated. As a result, “access to abortion risks being severely limited, seriously undermining women’s sexual and reproductive rights”, warns the HCE.
To overcome this supply difficulty, the Nordic Pharma laboratory offers an alternative imported from its Italian subsidiary. This is MisoOne 400 micrograms. “This specialty has the same level of quality and the same indications as the specialty marketed in France. It has the same misoprostol concentration, i.e. 400 micrograms”, underlines the laboratory.
The National Agency for the Safety of Medicines and Health Products also claims to have set up a “quota” to “manage the best stocks” available, with a ban on the sale and export of these drugs abroad.
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