Faced with the shortage of medicines, this is how patients are coping

in collaboration with

Dr Yves Dour (Doctor of Pharmacy)

“Imagine. Your kid has seizures except when he takes Sabril. Imagine. Sabril has been out of stock for weeks and your box will soon be empty. Imagine. Say @SanofiFR, will you tell us the rest of this beautiful story?“. Last May, the tweet from Giulia Foïs, journalist and mother of a six-year-old boy who suffers from epilepsy, highlighted the problem of shortages of medicines, some of which are essential for many patients.

Invited a few days later on various TV sets, she will talk about her concern about the risk that her son will one day not be able to take his treatment due to lack of shortage. A situation that is all the more worrying as the Necker hospital where his son is being treated has no solution. The specialist confirms that new boxes must be found quickly, but explains that she does not have any stocks.

Finally, solidarity via social networks will allow him to have treatment for his son this time. More than an isolated case, many patients live in the anxiety of no longer finding the treatment on which their daily life depends. To cope with this and without waiting for a system that puts them in danger to be overhauled, some have developed a “coping out” system based on mutual aid.

Patients who live in anxiety

Patrick Baudru knows this anxiety well too. “I am epileptic myself and I always manage to find my medicine, although I have to do it well in advance and sometimes I am given the generic instead of the original. But as administrator of the Epilepsie France association, I am regularly confronted with the stress and anxiety of patients, who fear not finding their medication in pharmacies.“.

The problem is all the more concrete in epilepsy, because patients are treated in a personalized manner. “Patients have their own treatment, composed of one or sometimes several molecules. It often happens that they have incomplete treatment, when one of them is missing“.

Coping with a system that puts them in danger

How do all these patients, whose treatment is essential? “We have a kind of support system” explains Patrick Baudru. “Nothing official, but we discuss shortages during discussion groups or during discussions on Facebook. Patients take the opportunity to ask if someone geographically close can help them out with this or that medication.”.

The administrator adds that he himself regularly “helps out” patients close to his home. “This may be my own treatment. I then give them a plate and they give it back to me later or even other molecules, which I store at home.”

The shortage is affecting more and more drugs

This D system is not only valid for epileptic patients. Numerous testimonies on social networks show that the problem affects many pathologies.

The results of a study by the France Assos Santé observatory report that “37% of people faced a shortage in 2023 compared to only 25% in 2018.. More serious: among these people, “45% had to modify their treatment or give it up”. Not without repercussions on their daily lives.

“For some epileptic patients, their treatment is truly what allows them to drive, to work, to simply be independent… A few months ago, a patient I know no longer wanted to leave the house because he could not didn’t have his medicine anymore, for fear of having a seizure outside” says Patrick Baudru.

Medicines mainly manufactured abroad

A case far from being isolated, because every day or almost, the list of the National Medicines Safety Agency (ANSM) on the availability of health products is enriched with a new product “out of stock” or in “supply voltage”. After a winter marked by shortages of amoxicillin and paracetamol, tensions continue.

“We are experiencing a recurring shortage of many molecules” confirms Yves Dour, pharmacist at Le Mans. Why? “Because the countries producing these molecules – China and India for paracetamol and amoxicillin, but not only – have been affected by Covid. They were therefore major consumers of paracetamol and produced it in smaller quantities for export, just like amoxicillin. And as 80% of the active substances consumed in France are manufactured in these countries, we quickly understand where the supply problem comes from.

To resolve this issue, the government is considering the return of this production to French territory. “There is a laboratory whose production has been relocated to Europe for amoxicillin” confirms Yves Dour. “On the other hand, for paracetamol, whose production costs remain high in France, a price negotiation will surely have to take place..

Last winter, the molecules were “contingent”, so that all pharmacies could have access to them. “We had to go through a wholesaler to supply us, and no longer directly from the laboratory, so that stocks could be distributed to all points of sale. Every day, we place two orders to get the medicines in supply. This is still the case for amoxicillin, I got eight boxes of it this morning, for example. You have to ask for more every day.” explains the pharmacist.

Adapt treatment quantities

The other approach put in place for a long time by pharmacists is the adaptation of the treatment to the number of days. “If we have a prescription for seven days of antibiotics but the treatment is a box of 10 tablets, we readjust the prescription by delivering the treatment for five days, so, which is sufficient, there is no need to issue another box. says the pharmacist again. According to AFP, the government should even go further by making the individual sale of certain drugs compulsory due to supply constraints.

Sometimes, he had to issue dosage forms other than prescriptions, to meet patient demand. “This is for example for children who have not been able to get amoxicillin syrup. We had to give them the equivalent in capsules, to mix in yogurt, or in dispersible tablets, to melt in water“.

Small arrangements between pharmacists, doctors…

As a last resort, Yves Dour explains that he made arrangements with colleagues for certain treatments and sent patients to another pharmacy to collect their treatment. “We were also able to ask certain doctors to ask them for “drawer” prescriptions with several molecules indicated on the prescription, so that we could deliver the one that was available, depending on stocks. We sometimes call them directly too”.

Sleight of hand and small arrangements that do not satisfy the health professional, even if “with hindsight, we see that there were no more hospitalizations, this shows that this rehabilitation system works, all the same“And if a treatment cannot be found, should you ask those around you or on the Internet, as some epileptic patients have done? “It can possibly be obtained this way, but I would recommend seeking the advice of your doctor or pharmacist before starting to take it.” he concludes.

Also be careful with substitutions without medical advice, certain medications are said to have “narrow therapeutic margin”, which means that any variation or modification in the concentration of active substance in the body, even low, can lead to certain undesirable effects (sometimes due to simply changing an excipient).

Finally, do not order your medicines on sites that do not offer the guarantees equivalent to a real pharmacy. Some fraudulent sites may sell drugs with less active ingredient, or even none or even another molecule.