France’s antibiotic stocks may be low until spring

Amoxicillin and paracetamol supply issues have highlighted dependence on chemicals from China and India

Persistent drug shortages have highlighted France’s dependence on China and India for essential chemicals.

In particular, paracetamol and amoxicillin, a common penicillin antibiotic, have become difficult to obtain from pharmacies, especially in pediatric doses.

It comes as the Senate will launch an investigation into the causes of the shortage, which also affects many other lesser-known drugs.

Two months to replenish amoxicillin stocks

According to the French magazine Marianne, the current “fiasco” is largely due to the fact that pharmaceutical companies, over the past 30 years, have moved the production of well-established drugs in order to be able to focus on new – and more profitable – “innovative” products.

Experts from the ANSM Medicines Safety Agency said they hope the amoxicillin shortage will end soon.

However, Health Minister François Browne said that while paracetamol supplies were expected to return “very soon”, it could take two months to replenish amoxicillin stocks.

Covid disrupted the import of the paracetamol molecule from China

A large part of the paracetamol tablets and syrup sold in Europe is produced in France, notably at the UPSA Dafalgan and Efferalgan plant in Agen in Lot-et-Garonne, and at the Sanofi plant in Lisieux in Normandy.

The latter is one of the most productive pharmaceutical factories in the world, typically making over a million boxes of Doliprane Paracetamol a day.

Both companies rely on commodity chemicals that have been produced since 2008 only in countries with low labor costs, including China and India.

Supplies of the paracetamol molecule from China have been disrupted since the start of the epidemic due to increased demand for symptomatic treatment.

However, in January Sanofi announced a record year for Doliprane production in 2022: 424 million boxes made.

The shortage was exacerbated by an epidemic of bronchitis in children

The situation was made worse in France by an outbreak of childhood bronchitis, which led to many children being hospitalized with respiratory problems, while others at home were prescribed paracetamol and amoxicillin.

French doctors prescribe paracetamol instead of aspirin, which has similar effects, due to concerns about stomach bleeding from aspirin.

The amoxicillin used in France is mainly manufactured in Eastern Europe.

It is used against bacterial infections of all kinds and is often prescribed here for children when there is a risk of bronchitis turning into pneumonia. For young children, it is often given in the form of syrup.

To help, the government said pharmacies could make and sell Magistral preparationsWhich means they can crush adult tablets and powder doses into syrups at kid-friendly concentrations.

Production delays at a new chemical plant in France

A project was launched by the French company Seqens, of which the American fund SK Capital Partners is the main shareholder, to open a chemical plant for paracetamol ingredients in France even before the Covid crisis.

It was favored during the crisis, including government subsidies.

Production at the company’s new €100m plant at the Roussillon (Isère) site has been delayed and is not expected to start until 2026.

Pharmaceutical companies’ profits are squeezed by the social security system

He also accused the French social security system of contributing to the shortage.

For years, the amount paid to pharmaceutical companies when doctors prescribe their products was so compact that it was more profitable to sell them in other European countries, such as Greece, than in France.

Faced with a shortage, the government issued decrees banning the export of paracetamol until the situation improved.

The sale of paracetamol on the Internet has also been suspended to stem profits.

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