Ruptures d'approvisionnement en médicaments anti-infectieux: causes et conséquences [Shortages in anti-infective medicines: causes and consequences]

Ruptures d'approvisionnement en médicaments anti-infectieux: causes et conséquences

Caroline Luans (1) , Isabelle Cardiet (2) , Pauline Rogé (1) , Béatrice Baslé (1) , Pascal Le Corre (1) , Matthieu Revest (3, 4, 5) , Christian Michelet (3, 4, 5) , Pierre Tattevin (3, 4, 5)

1 Service de pharmacie
2 COMEDIMS
3 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
4 CIC - Centre d'Investigation Clinique [Rennes]
5 Fonction, structure et inactivation d'ARN bactériens

Anti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs.

Mots clés: antibacterial; vaccine; drug shortages; anti-infective

Mots clés: anti-infectieux; antibiotiques; vaccins; Rupture d’approvisionnement

Domaines: Maladies infectieuses

Caroline Luans, Isabelle Cardiet, Pauline Rogé, Béatrice Baslé, Pascal Le Corre, et al.. Ruptures d'approvisionnement en médicaments anti-infectieux: causes et conséquences [Shortages in anti-infective medicines: causes and consequences]. Médecine et Maladies Infectieuses, 2014, 44 (10), pp.470-477. ⟨10.1016/j.medmal.2014.07.014⟩. ⟨hal-01077286⟩