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Pénuries de médicaments

Trois ans après le déclenchement de la pandémie de SARS-Cov2 nous subissons encore des pénuries à répétition. Malgré des incantations et des promesses de réindustrialisation, rien n’a changé.

Nous connaissons des pénuries majeures dans plusieurs classes de médicaments dont les plus connus sont le paracétamol (doliprane) et l’amoxicilline (Clamoxyl). Selon l’Agence Nationale de Sécurité du Médicament (ANSM), le nombre de signalements de ruptures de stock, ou de tensions sur les stocks, pour les seuls médicaments d’intérêt thérapeutique majeur est passé de 44 en 2008 à 1 504 en 2019 et 2 160 en 2021.

Les pénuries touchent beaucoup de pays. Par exemple, en Angleterre, et dans certaines pharmacies, les prix de l’amoxicilline ont pu être multipliés par dix ! 

L’Inde et la Chine sont les deux plus gros fabricants de médicaments au monde, la Chine fournissant plus de 80% des principes actifs.

Avant les délocalisations, la France fabriquait les principes actifs et les médicaments.

Les chaînes d’approvisionnements sont sous tension et la hausse des prix des matières premières augmente les coûts de production et complique la situation : hausses des prix des blisters à base d’aluminium, des emballages cartons, etc….

Il est un peu tard pour envisager une usine en France, la construction d’un site industriel ne se faisant pas en deux jours, sans oublier la sur-réglementation et les normes environnementales.

Les écarts de prix des médicaments entre les différents pays peuvent aussi inciter des laboratoires à combler les pénuries moins rapidement pour les pays dont les prix sont bas, la France notamment. 

Pourquoi les entreprises du secteur n’ont-elles pas stocké plus de 6 mois de demande ? Quelles furent les décisions politiques afin de sécuriser les approvisionnements ? Aborderons-nous un jour la question des choix stratégiques qui ont voulu la fin de la souveraineté du pays dans plusieurs domaines : énergie, santé… ?

Miser sur la « fin du zéro-covid » en Chine n’est pas non plus une solution pour remplir nos stocks d’autant qu’aucune alternative viable et structurelle n’est mise en place pour faire face aux pénuries.

Avant que la France ne se permette de donner des leçons, qu’elle regarde son bilan : un mauvais bilan en termes de décès avec près de 2340 morts par million d’habitant depuis le début 2020. Elle traverse la neuvième vague avec seulement 35% des personnes âgées de plus de 60 ans ayant reçu leur rappel vaccinal alors que les Anglais, autre mauvais élève, ont quant à eux une couverture vaccinale de l’ordre de 60% ! 

Citons également le Canada qui connaît une hausse de 25% des décès du covid par rapport à 2021, et ce malgré une bonne connaissance des modes de transmission, de prévention et de soins. Quel échec des politiques et de la Santé publique.

Comparativement, plusieurs pays d’Asie se situent aux alentours de 300 à 400 morts par million d’habitant. On peut citer parmi les meilleurs élèves des pays tels que Singapour, le Japon, la Corée du Sud.

Si la Chine s’inspire de ses voisins, et se décide à obtenir une transmission faible du virus alors l’occident pourra envisager une amélioration sur les chaînes d’approvisionnement. Notons que la directrice scientifique sortante de l’OMS vient d’exprimer ses regrets dans une interview, indiquant que l’agence aurait dû reconnaître la transmission par aérosol « beaucoup plus tôt ».

A l’inverse, si Pékin ne met pas en place des mesures pour réduire les risques de transmission aérienne (FFP2, détecteur CO2, purificateur d’air, information claire) alors le pays se trouvera vraisemblablement confronté à une vague incontrôlable dont les conséquences sanitaires seront majeures.

Il y a 1,4 milliard d’habitants, je vous laisse faire les calculs. Et qui sait, un nouveau variant émergera peut-être.

Quant aux chaînes d’approvisionnements et pénuries de médicaments, il est à craindre que les problèmes ne s’aggravent : en plus des perturbations dans les usines, une forte demande chinoise en médicaments associée à d’éventuelles réquisitions « bloquera » vraisemblablement nos importations.

Le problème et la solution passant par la Chine, souhaitons-lui de réussir. Notre santé en dépend.

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