Medicines: how the government wants to limit shortages

2023-09-16 07:45:10

Published on Sep 16, 2023 at 9:45 am

The government is seeking to strengthen its arsenal against drug shortages. To limit this booming phenomenon in recent years, and now well known to the French, he wants in particular to fight against unnecessary antibiotic prescriptions.

According to our information, the executive plans to generalize screening tests or rapid diagnostic orientation tests (Trod) in the event of shortages, thanks to a measure in the next Social Security budget, presented at the end of the month.

Concretely, before receiving antibiotics from a pharmacy, patients should first verify, using a test, that their illness is indeed of bacterial and not viral origin. Doctors would thus be led to prescribe antibiotics by conditioning them on the performance of a test.

Soaring drug costs

The government already indicated, at the end of August, that it intended to increase the use of Trod. The objective stated until now was to “better control” the volumes of prescribed medicines rather than acting only on the prices paid to laboratories to contain the soaring cost of medicines for Social Security. The government could, however, kill two birds with one stone by also highlighting the benefit of tests to combat shortages.

On the rise for several years and marked last winter, notably with difficulties in accessing a flagship antibiotic such as Amoxicillin, these shortages have led the government to identify some 450 critical drugs, to promise relocation measures and to provide one-off boosts to the prices paid to manufacturers.

Heated discussions with doctors

The prospect of new supply difficulties this winter is enough to push the government to encourage the use of tests. Since the summer of 2021, pharmacists have been able to carry them out to detect sore throats of bacterial origin, but their use is far from being common practice, underlined a report submitted this summer to the Prime Minister, Elisabeth Borne.

While these tests are recommended by the High Authority for Health (HAS) and presented as means of combating antibiotic resistance, only 1.2 million have been ordered by general practitioners for 9 million tonsillitis treated. And a large number of pharmacies did not offer Trod in spring 2023, noted the same report on the regulation of the drug.

Knowing that “other tests will arrive on the market in other pathologies”, its authors recommended that the executive “consider” making the delivery of antibiotics for tonsillitis conditional on the performance of a test in the pharmacist. And this, “from 2025” if there is no “substantial improvement” in the use of Trods by next summer.

It remains to be seen how doctors will react to the announcement of a measure affecting their prescriptions when they are already very upset about the checks carried out on sick leave prescriptions by Health Insurance. Relations between general practitioner unions and the authorities have been stormy in recent months amid demands over the prices of consultations. After the failure of negotiations between Health Insurance and doctors’ unions on the agreement linking them to Social Security, discussions are supposed to resume, a priori next month.

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