Drug shortage: “If nothing is done, products will disappear”

In the interview world, Pharmacist Bruno Bonnemain, vice president of the National Academy of Pharmacy, details the various causes of the current shortage and suggests areas for improvement.

Which drugs are currently affected by supply tensions?

First-line cancer drugs, antibiotics, and anti-inflammatory drugs were the most affected. But, in fact, all therapeutic classes were affected. These are mostly old, cheap drugs, mostly generics. We have There are a lot of breakdowns in pharmacies at the moment, But at least as much at the hospital level. Injectables, which are mainly used in hospitals, are much more damaged than dry forms.

What are the reasons?

The reasons are varied and vary by product and period. For example, at the moment, there are many problems related to the war in Ukraine, because the blisters on the packaging require aluminum, which mainly comes from this country. Same with glass. We even have the problem of supplying syringes to hospitals and vials to pharmacies. Apart from these phenomena Cyclic, are old structural phenomena.

Overall, there has been a move towards outsourcing and subcontracting production to other countries. First, because of the arrival of generics about twenty years ago, which confronted the pharmaceutical industry with the problem of margins on older products. This led to the relocation of production of raw materials and finished products to Asia to reduce costs.

Then, European environmental regulatory restrictions forced manufacturers to produce in Asia, especially India, where they are much weaker. Finally, the availability of generics has forced countries to offer extremely low prices. But we end up in a situation where the income is so low that no one can invest. In 2023, several products are expected to disappear from the French market.

What are the specific outcomes of this outsourcing?

This greatly complicated the production and product release chain. On this chain today, several actors can intervene so that the slightest grain of sand in the system complicates everything. Twenty years ago, companies manufactured products from start to finish and therefore controlled the entire supply chain.