Twenty products absent from the shelves of the pharmacy on the first day of the week. This is the situation that a small pharmacy owner in the fifteenth arrondissement of Paris, a few days of the summer closure of his pharmacy. An almost normal, and shared by many of his colleagues. These problems of supply disruptions, the pharmaceutical companies (LEEM) have also identified a few months. Front-line antiretroviral drugs (treatments against AIDS), insulin, or steroids. In some small pharmacies, such as supply disruptions related antidepressants and vaccines.
"The mountain of pharmacies in these areas have alerted us, says we in the trade association of the drug industry, because in general, breaks off and still found the result of bad weather, or social movements. " This was not necessarily the case in recent months."For some specific drugs, including antiretrovirals, there is a significant difference between the amounts made available to the distribution channel for businesses, and far below the number of units dispensed by pharmacies in town," confirms the organization.
In this case, then those products which go missing? According to Leem, some drugs would be captured by "short liners," the new intermediate appeared recently (4-5 years), whose intervention "aims to capture the margins, and do not have to Unlike the traditional players, a culture of health professionals ", warns Leem.And the controversy grew about the possible disruptive effect that these new players would result in the drug market.
Introduction of quotas
These new entrants are currently only 2.5% of the market for thirty entities in competition with wholesale distributors, who are the traditional intermediaries between laboratories and the approximately 23,000 French owners of pharmacies. "This is especially true for drugs produced and distributed in small quantities, such as antiretroviral (ARV) where their intervention significantly affects the fluidity of the market, says Emmanuel Déchin, general secretary of the Chambre Syndicale in the pharmaceutical distribution (CSRP) , which comprises seven members, representing 97% of the French market."We know that none of these ARV box which is sold is intended for the French market.".
In addition, since the early 2000s in France, every distribution is given by pharmaceutical companies, quotas based on national market share. "We understand the concern of an economic actor such as a laboratory to better control the flow of production, Emmanuel Déchin tempers. But it also induces more rigid and can penalize us and expose us to break. " Today, about 600 drugs on the 5300 allowed the French market are subject to these quotas. And strong demand in France for some products, lead to regular stock-outs on nearly 270 specialties, according to the Union of pharmacists (USPO).
Also, some advance to explain that the pharmaceutical giants, or even distributors, do not hesitate to reserve a portion of their stocks of the more "lucrative". Indeed, patented products still sell for an average of three to five times more expensive in the U.S. than in France. And even within the European Union, large disparities persist. On average, the products can be sold 20% more expensive in Germany than in France, while in Spain, prices are generally lower than 10%. "I do not honestly believe that a laboratory, despite its economic imperatives, can do this type of arbitrage to the detriment of the health of patients' tempers Déchin Emmanuel.
The health minister is prepared to legislate
For his part, and face these charges, the Health Minister Xavier Bertrand was firm: "These systems are known to parallel importation, but I do not want that.What is planned for France should be consumed in France, "he said on Europe 1 radio on Tuesday. He was prepared to legislate if laboratories and wholesalers did not meet their obligations, "or you meet your quota, or I will oblige with a new text, he said. It's a shame to come here but I will not hesitate one second to do so. "
Therefore, to overcome these difficulties, some small pharmacists have no choice but to defeat the usual, explains that another pharmacist in a small pharmacy (800,000 euros of annual turnover): "either we manage with co-major pharmacies that are generally better off than us, or we go directly to the laboratory control. But this can only be temporary, because of course we pay more than the wholesaler! ".For two or three years, the pharmacist admitted being increasingly confronted with such situations, including antiretrovirals and cancer. Clearly, treatments that can not wait. Troubleshooting
Faced with this shortage, Leem and the French Agency for Safety of Health Products (AFSSAPS) have set up emergency solutions (stocks troubleshooting, short circuit …) and special issues to avoid the maximum out-of treatment for patients. A temporary workaround, which can not do without an in-depth study of the new challenges of the French system of drug distribution. What the Department of Competition and Fraud (DGCCRF) seems to be addressing.
In turn, dispatchers did not call for the abolition of quotas, nor to that of intra-EU trade, but felt that the resolution of this issue "very complex" pass through "pragmatism and a sense of responsibility on the part of all actors in the chain, given the economic pressure to which they are subjected. "
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