Faced with tensions over the supply of medicines, which have continued worsened in 2023“resourcefulness” prevails among pharmacists to be able to provide their patients with antibiotics, but also analgesics, corticosteroids, paracetamol, antidiabetics or vaccines.
“We are in a form of DIY,” sighs Florence Guer, pharmacist in Marseille. “We go out of our way, but it’s exhausting. Some colleagues try to make small stocks, just to be able to breathe and not go fishing for something missing every day, but it’s no use: what’s going to be missing is always different,” she describes.
Difficulties in supplying medicines, a recurring problem in France as in other countries, have worsened in 2023: nearly 5,000 reports of shortages and risks of stock shortages have been recorded by the Medicines Agency (ANSM), i.e. +30% in one year. They have more than doubled compared to 2021. Manufacturing problems, quality defects, insufficient production capacity and increased needs due to aging populations: the causes are multiple, according to the ANSM.
Medicines stakeholders (industrialists, dealers, wholesalers-distributors, community and hospital pharmacists) have promised to better organize yourself to combat shortages, in a charter signed in November with the Ministry of Health. But the situation remains tense in pharmacies, according to professionals.
“Every day, the word I use the most is “rupture””, confirms Fabrice Camaioni, vice-president of the main community pharmacists union FSPF, pharmacist in the Ardennes. To get through it, “it’s always the same recipe: for this medication that I don’t have, can I give a generic? It is still necessary that he himself does not break away. Can I find it from a colleague? Do the labs have a troubleshooting box? », he lists.
“Once or twice a day, I go and get a box from my colleagues, and I give as many,” adds Guillaume Racle, pharmacist preparer and economist advisor to the USPO, another union.
“In fact, there are no more rules. We have the impression that it happens all the time, and that it affects all families of medications (…) We fight every day so that people follow their treatment well, and we find ourselves from one day to the other to tell them to cut it off because we have nothing left. It drives me crazy,” he adds.
Such an interruption of treatment can mean “a loss of opportunity for the patient”, recalls Catherine Simonin, member of the office of France Assos Santé, a federation of patient associations. These extreme situations nevertheless remain “exceptional”, nuance Fabrice Camaioni. “We usually manage to find a solution. But it could be a “degraded solution”, such as substituting the preferred drug, called “first line”, with a product with potentially more serious side effects, according to him.
12 hours per week
However, this is very time-consuming. According to a study by the Union of Community Pharmacists Unions (USPO), the time spent managing these supply tensions is around twelve hours per week.
Supply circuits can vary between pharmacies in the same region, or even the same city, depending on contracts concluded between manufacturers, suppliers and pharmacies. But the players agree on one point: a lack of reliable information, according to them, on the state of stocks and supplies, in particular because pharmacists and manufacturers use two distinct information networks, which do not communicate. .
“In 2020, the Biot report recommended the creation of a kind of + control tower + for medicine to centralize information, then Covid passed through and we had no more news,” underlines Catherine Simonin, pleading for the creation of a single information monitoring office, “why not at European level”.
“We cannot resolve this problem without having reliable data across the entire chain. The first of the measures is this. We must be able to know exactly where the drugs are,” confirms Guillaume Racle.