Medicine shortages in France: a 6-year retrospective study in a university medical centre

Objectives Medicine procurement disorders, commonly referred to as 'shortages', are a health-threatening phenomenon that have been reported by several stakeholders around the world. This study aimed to describe data from a mitigation tool, namely a shortages report implemented within one of the largest university hospitals in France over a 6-year period. Methods For 6 years (from 1 June 2014 to 31 May 2020) the data used were collected from different sources: purchasing groups, distributors, manufacturers and the national health agency. The report included: medicine identification, disorder duration, starting and ending dates, available alternative products, the Anatomical Therapeutic and Chemical (ATC) classification. Different situations were described: medicine shortages, quotas, supply tensions and market withdrawals. Results Over the 6-year period, 1780 disorders were registered comprising 0.67% market withdrawals, 16.97% quotas, 79.89% shortages and 2.47% supply tensions. The median duration of a disorder was 56 days and the most affected ATC classes were the nervous system (N), anti-infectives (J) and the cardiovascular system (C). A substitute medicine was registered for one-third of the disorders. In the N class, the most frequent level 4 classes were N01BB (local anaesthetic amids such as lidocaine, levobupivacaine and ropivacaine), N03AX (other antiepileptics) and N05AX (other antipsychotics). In the J class, the most frequent level 4 classes were J01CR (penicillin combinations), J01CA (extended-spectrum penicillins such as piperacillin and amoxicillin) and J01XX (other antibiotics for systematic use). Conclusions Procurement disorders are still spreading. The study results are similar to those of other research teams around the world. Common answers have to be found to deal with the phenomenon, that include standardisation and risk assessment methods.