As France grapples with the ‘triple epidemic’ of influenza, Covid-19 and bronchiolitis, pharmacies are also short on specific drugs.
The shortage primarily concerns two medications: the over-the-counter drug paracetamol (Tylenol) – usually sold under the brand name Doliprane in France – and the prescribed antibiotic amoxicillin.
According to Franceinfo, approximately 70 percent of French pharmacies were out of stock of amoxicillin as of January 6th, which is of particular concern to pediatricians as this is the antibiotic often prescribed to children.
In an attempt to alleviate the shortages, the French National Agency for the Safety of Medicines and Health Products (ANSM), which monitors the availability of pharmaceutical products, decided at the end of December to allow pharmacies to produce amoxicillin themselves, “on an exceptional and temporary basis,” according to Franceinfo.
At the beginning of January, the government also banned the online sale of paracetamol-based products until the end of the month.
READ MORE: France bans online sale of paracetamol over shortage fears
Doliprane is widely taken for a variety of mild health problems such as headaches, joint pain, flu and period pain, while amoxicillin is the most-prescribed antibiotic for children suffering from illnesses including ear infections and sore throats.
Over a hundred other medications are also in short supply, such as two drugs used to treat Type 2 Diabetes – Ozempic (semaglutide) and Trulicity (dulaglutide). You can find the full list of medicines with strains in supply HERE.
On Tuesday, Brigitte Autran, the head of the Committee for Monitoring Health Risks in France (COVARS), said that there was a “problem with [the lack of] paracetamol in France,” adding that the shortage has also impacted other European nations as well.
While the shortage has been going on for several weeks, it has more recently been exacerbated by the fact that significant portions of France’s paracetamol supply is produced in China, where the country is experiencing a high wave of Covid-19 infections.
As a result, the COVARS head did not offer an exact timeline for when supplies would return to normal.
The situation is also bit complicated for the antibiotic amoxicillin, and an exact timeline is “difficult to predict” according to the minister. The French minister of health said in November that he hoped the shortage of this drug will be resolved within at least the “coming weeks and months.”
How has the shortage affected patients?
In addition to limiting online purchases until the end of January, French pharmacies have taken specific actions to remedy the shortage of over-the-counter paracetamol, which has been in short supply since July. Specifically, pharmacists have limited the maximum number of boxes sold to two per person (without prescription).
On the other hand, doctors have been asked not to prescribe paracetamol unless there is “an identified need.”
As for amoxicillin, it is the primary antibiotic prescribed to children facing bacterial infections, such as ear infections, in France. However, due to the shortage, health authorities have asked doctors to only prescribe this medicine when absolutely necessary.
In November, the National Agency for the Safety of Medicines and Health Products (ANSM) alerted the public that a strong “strains in supply” could last until March for amoxicillin.
What is the government doing in response?
In addition to authorising pharmacies to begin producing amoxicillin themselves, “on an exceptional and temporary basis,” in November, the French government called on medicine manufacturing industry to increase their production lines by working at maximum capacity – seven days a week and 24 hours a day – to return the paracetamol supply levels to normal.
The French government has also prohibited the resale of amoxicillin to other countries.
Are other medicines affected?
So far, paracetamol and amoxicillin have been the focus of alerts from health authorities, and the shortage is due to specific issues with those drugs (see below).
As for other medications, the ANSM keeps an ongoing list of any drugs in short supply or at risk of being in short supply. By searching the drug’s generic name (i.e. the active ingredient) on their list, you can see all other medications concerned.
If you have other medications prescribed that do not appear on the list above, there should be no problem in getting the drugs that you need.
What is the reason for the shortage?
For paracetamol products specifically, one primary issue is that a large part of production takes place in Chinese factories. Due to the high wave of Covid-19 infections impacting China, several factories stopped exports to reserve the medicines for Chinese patients, according to RTL.
Health authorities also believe the medicine shortages are due to an increase in demand – thanks to a higher spread of seasonal illnesses such as colds, flu and bronchitis after two years of Covid-related lockdowns and protective measures.
“This year, from January to October, the demand for amoxicillin is around 40 million boxes, whereas in 2020 and 2021 it was much lower, around 30 million boxes,” a representative from the ministry of health explained to Les Echos.
Additionally, part of the problem is related to production and manufacturing. Due to a drop in demand during the pandemic, manufacturers reduced their production. Now they are being asked to return to pre-pandemic production levels.
According to the minister of health, this also signals the need for medicines to be produced in France, as the majority of raw materials currently come from Asia. He also said that ‘medicine sovereignty’ would be an important aspect of the government’s 2030 investment plan.
READ MORE: Why do the French love medication so much?
Finally – for amoxicillin specifically, part of the cause of the shortage is due to over-consumption in France. The health ministry noted that “at least half of all antibiotic prescriptions in France are medically unjustified,” as the drug only fights bacteria, not viruses like bronchitis or flu.