In an annex building of the Delpech pharmacy, in the 6th arrondissement of Paris, a laboratory of barely 15 square meters. ” There you are in the amoxicillin production room. And you have my two co-workers giving me a hand “says Rachida El Hssaini, one of the three pharmacy assistants.
Mask on the face, charlotte on the head and white coat, the three women receive orders from pharmacies and prepare capsules of pediatric amoxicillin. The antibiotic comes as a white powder in a large tub. For each magistral preparation, it is first necessary to evaluate the quantity of powder necessary: ” For this preparation, the software asks me to weigh 172 grams, and you have to be precise! »
The capsules, first empty, are placed in a capsule filler, then filled with amoxicillin powder. The tablets are prepared in batches of 300. A treatment for one patient corresponds to 15 capsules (3 capsules for 5 days). With 300 capsules filled all at once, 20 treatments for 20 patients are therefore carried out during each preparation.
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Objective: 30% of national production of amoxicillin
The laboratory is equipped to produce in large quantities. The three preparers each have a role. Rachida El Hssaini weighs the amoxicillin, her colleague fills them, a last one conditions them by putting them in pots of 15 tablets. Since December, this small laboratory has been running at full speed: “ These are all pending orders “Explains Rachida El Hssaini, pointing to a bin full of cards. ” So, we will prepare them as we go along. Yesterday, for example, I did 1 700 preparations. But when you have machines like that of 300 capsules, in 3 minutes, we did the preparation from A to Z. It goes very quickly. »
Fabien Bruno, the incumbent pharmacist, controls the production directly on a television screen. It communicates directly with the ANSM, the National Medicines Safety Agency. Each week, he sends his production figures to the agency, which assesses the level of the shortage: “ The 40 subcontractors, all together last week, produced 435,000 capsules of amoxicillin, which represents approximately 30,000 treatments. The objective that we had set ourselves with the ANSM, at the start of the crisis, at the end of December, was to make about 30% of the national production of pediatric amoxicillin, and there, overall, we are on these trends. »
Avoid shortages by raising prices
The Delpech pharmacy is one of the 42 pharmacies authorized by the ANSM to produce pediatric amoxicillin. A welcome help, while the antibiotic is still absent from the shelves of pharmacies. “ It’s mostly an emergency solution. “, points out Philippe Besset, president of the Federation of Pharmaceutical Unions of France. ” A solution to deploy as much as possible when shortages threaten. »
But the real problem, for this trade unionist, is the price of certain drugs. Sometimes the prices are ridiculous, and the pharmacies therefore buy them at a lower cost from the laboratories. But this does not encourage manufacturers to produce them, for lack of profitability: ” Manufacturers favor the manufacture in Europe of drugs with high added value and they relocate first-line drugs to countries such as China and India. Therefore, we must regain autonomy over these drugs of major therapeutic interest and we will have to accept an increase in the price of these drugs.. »
Today, the vial of pediatric amoxicillin is sold for 76 cents to pharmacists. For Philippe Besset, it should be sold ” 3 or 4 euros to encourage manufacturers to continue production.