Cancer patients, first affected by the shortage of drugs

Relocating the production of certain drugs to France or Europe could make it possible to fight against the frequent shortages which affect many drugs, and therefore many patients.

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• In 2019, the National Agency for the Safety of Medicines and Health Products (ANSM) received nearly 1,500 reports of medicines in difficulty or out of supply.

• Generic drugs, very inexpensive but important in cancerology, are particularly affected.

• The League against cancer launched on Monday a mobilization campaign to give voice to patients, the first concerned.

“Dear patients, for your medicine, please wait.

The League against cancer sounded the alarm on Monday in a new awareness campaign on the shortage of drugs, especially those used in cancer treatments.

Faced with the worsening shortage of drugs, the League against cancer has chosen to give voice to patients, the first victims of the lack of stocks.

What drugs are affected?

Why are cancer treatments affected?

Is this shortage linked to the coronavirus epidemic? 

takes stock and explains everything to you.

• Why are we talking about shortages?

  What drugs are affected?

In 2019, the National Agency for Medicines and Health Products Safety (ANSM) received 1,499 reports of medicines in difficulty or disruption of supply, "a record with 34 times more shortages reported than in 2008", explains the League Against Cancer in a press release.

Among them, generic drugs, very inexpensive but important in cancerology, are particularly concerned.

"The first affected are always cheap drugs, therapeutic innovations that cost the skin of the buttocks, we never miss them", indignant Professor Jean-Paul Vernant, hematologist engaged in the battle.

One of the drugs affected is intravesical BCG, a drug used in the treatment of non-invasive bladder cancer.

"In a number of cases, certain bladder cancers which were perfectly kept in check by intravesical instillations had, due to the shortage of these drugs, to undergo a total cystectomy (removal of the bladder) "With consequences that disrupt the lives of patients, reports Axel Kahn, president of the League against cancer.

“These drugs, if they are not available, can have dramatic consequences: loss of opportunity for patients,” adds Amandine Courtin, advocacy manager at La Ligue contre le cancer.

• What are the reasons for this shortage?

For the majority of treatments affected by difficulties or supply disruptions, they are "drugs for which the patent has fallen into the public domain, so there is more competition, and necessarily less economic interest and profitability than for a drug manufactured by a single laboratory ”, explains Amandine Courtin.

"Gradually, the laboratories stop the production of these drugs to devote themselves to other drugs, exclusive, therefore more profitable", continues the advocate.

The other problem is the relocation of the production of active substances.

“Right now, 60% of the raw materials for medicines are made in India and China.

India and China being particularly affected by the epidemic, the production and export of certain drugs or certain substances were quite simply suspended with the epidemic, ”explains Amandine Courtin.

For Gérard Raymond, president of France Assos Santé, it is “the supply and forecasting circuit that is not optimal.

As for the distribution, it absolutely must be reviewed ”.

• Is this shortage linked to the coronavirus epidemic?

If the coronavirus epidemic has made it possible to highlight the shortages of masks, gowns or respirators, the drug shortages "in no case were created by the Covid", recalls Professor Axel Kahn.

It is "really a problem which is linked to the economic structure of the drug market", and which concerns "essential drugs", mainly generics, very inexpensive.

If Gérard Raymond shares this opinion, he nevertheless believes that the epidemic "has been a revelation and an accelerator of this problem".

“We realized that some drugs were no longer produced in China and India.

And with the epidemic, the production and export of these drugs were quite simply suspended, ”adds Amandine Courtin.

• What does La Ligue contre le cancer offer?

However, in France, there is indeed legislation.

New measures, introduced in the public health code in 2016, require manufacturers to ensure an appropriate supply to cover the needs of patients in France.

The League against cancer is demanding in particular financial sanctions against laboratories that do not ensure this supply.

For several years, associations have also campaigned to force European manufacturers to hold stocks of four months of drugs "to avoid prolonged shortages", explains Professor Axel Kahn.

“Medicines are not a common consumer good.

We do not choose to take a drug, but if we do not have it, we know that it can have dramatic effects in certain cases ”, warns Amandine Courtin.

The creation of an information system on current drug shortages, their durations or even the drugs available to replace the missing product was also requested by the associations.

"Sometimes, doctors do not even know if the drugs they are prescribing are available," protests Amandine Courtin.

There remains the question of the relocation of drug production factories.

Among the solutions put forward, to avoid too much dependence on India and China, some associations are pleading for the creation of a public establishment that would manufacture at cost price.

“It's great to think about relocating drug production, but it will take several years.

We will not be able to do it overnight, continues Amandine Courtin.

The question is: what do we do while waiting for these patients without treatment?

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