A pharmacist shows a box of - Damien Meyer / AFP
- If the effectiveness of chloroquine against Covid-19 is still under scientific evaluation, the rush in pharmacies on Plaquenil, one of the drugs based on this molecule, has already started.
- To the point that patients with lupus or rheumatoid arthritis sometimes struggle to stock up on Plaquenil, a drug that is the basis of their treatment.
- The Sanofi laboratory ensures that there is no shortage on the horizon. In addition, to secure supplies, a decree published Thursday frames the prescriptions of this drug. But the patient associations remain on their guard.
It was an anonymous phone call that broke the record. "A little over a week ago, a person contacted me to tell me that they had obtained many boxes of Plaquenil and that they offered to resell the associations of patients usually treated with this drug," says Johanna Clouscard, president of Lupus France. He did not have time to offer me a price, I immediately saw red. "
It's hard not to have heard of Plaquenil in recent days. This drug, produced by the Sanofi-Aventis laboratory, is based on hydroxychloroquine, the molecule recommended by several doctors, including Professor Didier Raoult, director of the Institut hospitalo universitaire Méditerranée Infection, to treat patients with coronavirus. Its use nevertheless divides the medical world, the effectiveness of this antimalarial being still under scientific evaluation. This is the subject of the European clinical trial Discovery, which is testing several molecules, including chroloquine, to find a therapeutic remedy for Covid-19.
Basic treatment for lupus or rheumatoid arthritis
But Plaquenil is also the basic medicine to treat lupus or rheumatoid arthritis, two autoimmune diseases for which the medicine has a marketing authorization. The first occurs when the immune system attacks and destroys cells in the body. "There are no official figures, but the disease affects around 40,000 people in France, says Johanna Clouscard, 36, herself suffering from the disease. It most often attacks the skin, kidneys and joints, but the damage can be much wider. And there is no cure, Plaquenil, with other drugs, just stabilizes the disease. "
Rheumatoid arthritis, which affects 300,000 people in France, is a chronic inflammatory disease of the joints evolving by inflammatory flares, describes Sandrine Rollot, national secretary of AFPric (French Association of polyarthritics and chronic inflammatory rheumatism). In the absence of basic therapy, rheumatoid arthritis can lead to irreversible deformity or even joint damage. One of its basic treatments is Plaquenil.
In both cases therefore, Plaquenil is very often a treatment taken daily and over a long period. Johanna Clouscard has been taking it for 17 years, at two doses of 200 mg per day. And no question of stopping overnight. "The effects are very quickly felt, resumes the president of France Lupus. These are joint pain, the face swelling and on which appear red patches. "
A rush in pharmacies since mid-March?
However, this is the scenario feared by patients on chloroquine since the molecule is presented as a possible miracle cure against the coronavirus. That of a general shortage of Plaquenil, the result of a rush in the pharmacies of the French in search of the drug. Friday, in a press release, the national academies of medicines and pharmacies were worried to see "numerous purchases of hydroxychloroquine by non-affected people, often for more preventive than curative purposes".
How to explain it when Plaquenil is a drug prescribed only on prescription? "It has been prescribed a lot to patients in recent days, by general practitioners, as a preventive measure," said Carine Wolf-Thal, president of the National Council of the Order of Pharmacists.
"There is a traffic of prescriptions to get chloroquine or antimalarial products approaching it, we know it", also declared Jean-Philippe Lecouffe, assistant director of the judicial police of the national gendarmerie, in a interview at 20 Minutes , Thursday.
Result: patients with lupus or rheumatoid arthritis have encountered difficulties in obtaining Plaquenil in recent days. Witness the messages left on the Facebook pages of Lupus France and AFPric. "From mid-March," says Sandrine Rollot. Johanna Clouscard experienced this this week in Tarn, where she lives: "I had to call five pharmacies before finding one able to provide me with a box of Plaquenil [which can last fifteen days ]. "
Strict supervision of deliveries since Thursday
Difficulties about to be resolved? As of March 22, Sanofi set up a troubleshooting system allowing pharmacists who no longer have Plaquenil in stock to be supplied more quickly. And this Friday, the laboratory announced that it had restocked all the wholesalers so that all pharmacies could order new Plaquenil from Monday.
In parallel, the government published on Thursday a decree framing the sale of Plaquenil and Kaletra (indicated against HIV and also containing the molecules tested in the European clinical trial). The text authorizes the prescription of hydroxychloroquine against Covid-19. "But they are reserved for the hospital and can no longer be done by doctors in town," says Carine Wolf-Thal. One way to reserve the molecule for the most serious cases of coronavirus. In all other cases, only prescriptions for which Plaquenil has a marketing authorization (MA) are authorized. It is therefore the case for lupus and rheumatoid arthritis.
Associations that remain on their guard
What stop the rush in pharmacies looking for chloroquine? Johanna Clouscard remains on guard. "Again on Saturday, someone from Marseille contacted me to tell me that they were having a hard time finding Plaquenil," she illustrates. Nor is the anonymous phone call from a drug dealer reassuring. For fear of running out, lupus patients could give in to this type of offer and buy exorbitant prices for Plaquenil, or even buy counterfeits. "
Our file on the coronavirus
"The issue of stocks and lead times remains a concern," says Sandrine Rollot, for AFPric. For example, the association recommends that people with rheumatoid arthritis refill Plaquenil prescriptions fifteen days in advance. She also continues to twist the rumors. "Some members have told us, for example, about the words of pharmacists assuring them that hydroxychloroquine was reserved for hospitals, this is of course false," continues Sandrine Rollot. The association has set up an online platform, dedicated to coronavirus, where people with rheumatoid arthritis can report the difficulties encountered in their supply of Plaquenil. They are then reported to the health authorities.
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