Epidemics and drug shortages: pharmacists on the front line
Paris, Tuesday, January 10, 2023 – Pharmacists are calling for better management of TRODs, while the drug shortage continues.
Last Friday, during his greetings to health professionals, Emmanuel Macron spoke at length about the problems of the public hospital and city medicine, but had no word for pharmacists. While we regularly talk about overcrowded emergencies and the demands of liberal doctors, the problems of pharmacists seem somewhat relegated to the background at the start of 2023. However, they too are faced with difficulties, whether dealing with the management of epidemics or the supply of medicines.
Precisely on the epidemic level, the situation is certainly rather improving, whether on the front of Covid-19 (the 9th wave has been in sharp decline since mid-December) or seasonal flu (the peak seems having been reached at Christmas), but the number of contaminations remains at a high level and a rebound cannot be ruled out following the start of the school year.
In this context, the Federation of Pharmaceutical Unions of France (FSPF) asked on Monday that the Health Insurance take charge of the TROD of the flu, “an essential public health measure” explains the press release from the union. “Community pharmacists are faced with numerous requests to carry out flu screening tests, the conditions for taking charge of which are currently difficult to read” writes the union.
Still no recommendation on double testing
Another epidemic prevention tool that the unions want to develop, the double flu/Covid-19 tests, which make it possible to detect the two viruses thanks to a single nasal swab, but which are still relatively rare in pharmacies and doctors’ offices. For the moment, these double tests are not the subject of any recommendation by the medical authorities, to the chagrin of the unions of pharmacies. But according to the High Authority for Health (HAS), the publication of an opinion on these tests will “take time”.
Another thorn in the side of pharmacies, unfortunately increasingly recurrent supply shortages and tensions. It is already certain that the year 2022 will break a record in terms of reports of tensions and shortages of medicines in pharmacies: in September, the National Academy of Pharmacy already listed more than 3,200 reports, compared to only 2,446 on the whole of 2020, in which the previous record was set.
The most publicized supply difficulties are of course those concerning paracetamol and amoxicillin, particularly in their pediatric forms. The various and varied restriction and quota measures are multiplying to limit the impact of this shortage: ban on the online sale of paracetamol, supervision of distribution by wholesaler-distributors, limitation of prescriptions, masterful preparation of amoxicillin in pharmacies…
No improvement “before the end of the month” for paracetamol
These two drugs, among the most consumed and prescribed in France, are unfortunately not the only health products affected by these tensions: in recent days, several corticosteroids (prednisolone and prednisone in particular) and vaccines (against hepatitis A and B) have subject to quota measures decided by the National Medicines Safety Agency (ANSM).
To organize the response to this ongoing crisis, in particular due to the epidemic situation in China which has sharply reduced its exports of active products and medicinal products, weekly meetings are now organized between the ANSM, the laboratories and the representatives of the health professionals (and in particular of course pharmacists). The opportunity for pharmacy unions to point out a major problem: the lack of transparency in the supply chain and the constant discrepancy between laboratory stocks and those of pharmacies.
“The ANSM told us that drugs were going to come back and even that this should already be the case for some, but in practice we see nothing” observes Pierre-Olivier Variot, president of the Union of pharmacists’ unions of pharmacy (USPO). Given the gap between stocks, Philippe Besset, president of the FSPF, believes that on the paracetamol front, “it seems difficult to imagine an improvement in pharmacies before the end of the month”. In the meantime, pharmacists are therefore condemned to manage the shortage.
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