It’s a growing disease for which the global economy is struggling to find the miracle cure… Drug shortages have been steadily increasing for a decade in the world, fueling demands from NGOs and even industrialists.
In 2021, the French Medicines Safety Agency (ANSM) therefore received 2,160 reports of out of stock and risk of out of stock. With problems in particular on insulins, essential in the treatment of diabetes, and on antibiotics.
On Friday, the Ansm spoke of “strong tensions” in supply on the oral form of amoxicillin, an antibiotic widely prescribed in children. A few weeks ago, its US counterpart, the Food and Drug Administration (FDA), did the same.
Production concentrated in Asia
The molecules currently under tension in rich countries have been lacking in developing countries for some time, recalls Gaëlle Krikorian, a health sociologist, who has just published an essay on the issue: “What has changed is that now the problems of access to molecules arise also in the northern countries”.
“What is often referred to as market failure is multiplying everywhere and it is becoming clear that these are not occasional system failures,” he adds.
The explanations, many, are known: with globalization, the production of active ingredients – which give their effectiveness to drugs – is now concentrated in a few Asian countries. A problem on the production line and the just-in-time system crashes.
Everyday drugs are becoming harder to find because they are less profitable than innovations and are of no interest to manufacturers
Another cause: due to the lack of an economic model for some drugs, such as antibiotics, often already sold in generic form, large laboratories tend to abandon diseases. Or overlook developing markets less able to pay high prices for molecules.
On the one hand, drugs that are no longer of interest to laboratories. On the other hand, ultra-expensive innovative treatments that do not interrupt supply but weigh on the budget of health systems.
Patent challenge: a decision expected this Wednesday
Faced with this, many NGOs are campaigning especially for the questioning of patents. Doctors of the World is therefore awaiting a decision from the European Patent Office on Wednesday, with which the NGO has filed an appeal regarding a cure for hepatitis C, initially marketed at 41,000 euros by the Gilead laboratory.
“Medicine makers have retired from research since the 1980s and have become dependent on start-ups for patents,” which they have to buy back at great expense, explains Olivier Maguet, head of the drug pricing mission at Médecins du Monde.
As a result, he says, “everyday medicines are becoming increasingly difficult to find because they are less profitable than innovations and are of no interest to manufacturers.”
The sociologist Gaëlle Krikorian therefore proposes amending the legislation, reflecting “on the development of collective rights (on patents, ed), because medical research is, after all, a collective effort” (particularly through public research funding).
NGOs are also fighting for greater transparency on prices, which are negotiated between each country and each laboratory in complete confidentiality.
Without forgetting the need to preserve or recreate regional production for some essential molecules. This is what the French laboratory Delbert wants to do, which markets around fifteen old drugs, including amoxicillin in injectable form… Which it does not market in France, where the price set by the authorities is too low, around one euro per box, says Thierry Hoffmann, CEO of Delbert.
“In wanting to reward innovation alone, we forget that the system of care exists through old products, which are absolutely essential in the therapeutic arsenal,” he notes.