title: Causes and consequences of anti-infective drug stock-outs.
abstract: Anti-infective drugs stock-outs are increasingly frequent, and this is unlikely to change. There are numerous causes for this, mostly related to parameters difficult to control: i) 60 to 80% of raw material or components are produced outside of Europe (compared to 20% 30 years ago), with subsequent loss of independence for their procurement; ii) the economic crisis drives the pharmaceutical companies to stop producing drugs of limited profitability (even among important drugs); iii) the enforcement of regulatory requirements and quality control procedures result in an increasing number of drugs being blocked during production. The therapeutic class most affected by drug stock-outs is that of anti-infective drugs, especially injectable ones, and many therapeutic dead ends have recently occurred. We provide an update on this issue, and suggest 2 major actions for improvement: i) to implement a group dedicated to anticipating drug stock-outs within the anti-infective committee in each health care center, with the objectives of organizing and coordinating the response whenever a drug stock-out is deemed at risk (i.e., contingency plans, substitution, communication to prescribers); ii) a national reflection lead by scientific societies, in collaboration with government agencies, upstream of the most problematic drug stock-outs, to elaborate and disseminate consensus guidelines for the management of these stock-outs.
authors.affiliation: Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France.
authors.forename: C
authors.initials: C
authors.lastname: Luans
authors.affiliation: COMEDIMS, CHU Pontchaillou, 35033 Rennes Cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Cardiet
authors.affiliation: Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Rogé
authors.affiliation: Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Baslé
authors.affiliation: Service de Pharmacie, CHU Pontchaillou, 35033 Rennes Cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Le Corre
authors.affiliation: Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France.
authors.forename: M
authors.initials: M
authors.lastname: Revest
authors.affiliation: Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France.
authors.forename: C
authors.initials: C
authors.lastname: Michelet
authors.affiliation: Service des Maladies Infectieuses et Réanimation Médicale, CHU Pontchaillou, 35033 Rennes Cedex, France; CIC-Inserm 0203, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France; Inserm U835, Faculté de Médecine, Université Rennes 1, IFR140, 35000 Rennes, France. Electronic address: pierre.tattevin@chu-rennes.fr.
authors.forename: P
authors.initials: P
authors.lastname: Tattevin
mesh_terms: D000890:Anti-Infective Agents / Q000600:supply & distribution*; D004345:Drug Industry / Q000458:organization & administration / Q000706:statistics & numerical data; D005602:France; D006801:Humans
chemical_list: D000890:Anti-Infective Agents
keywords: Anti-infectieux; Anti-infective drugs; Antibacterial; Antibiotiques; Drug stock-outs; Rupture d’approvisionnement; Vaccine; Vaccins