“There is no break. If the Minister of Health wants to be reassuring, many pharmacies are struggling to sell an abortion pill, misoprostol. François Braun concedes the existence of a “tension” but recalls that “access to this abortion pill is possible everywhere” and that, “if you can’t find [misoprostol] in pharmacies […], it is always available in the hospital […], and the centers that practice the voluntary termination of pregnancies have boxes available”. Monday, April 17, in a letter addressed to the Minister of Health, the PS vice-president of the Senate, Laurence Rossignol, considered that the shortage had taken “another step” and that it “affect[ed] the right of women “.
According to the Observatory of Transparency in Medicines Policies (OTMeds), misoprostol has been or still is very difficult to find in certain places in France, such as Lille, Versailles, or Issy-les-Moulineaux. “We recently received new testimonials indicating that it is not available either in Occitanie or in certain Parisian pharmacies”, recently completed Pauline Londeix, co-founder of OTMeds.
What is it about ? Misoprostol is an abortion pill that causes the expulsion of the embryo. As part of a medical abortion, it is necessary to take two different pills. Misoprostol should be taken 36 to 48 hours after mifepristone. It should also be used upstream of non-drug abortions.
Currently, there are no generics or equivalents to misoprostol. This medicine is under patent, so there is no alternative. “This concentration of production makes the supply chain vulnerable. In the event of an industrial problem, impurities, production lines slow down or stop, and there are no fallback solutions to keep production up to world demand. Local, diversified, at least partly public production is a pragmatic response to this problem”, suggests the Observatory of transparency in drug policies in its point of April 18, 2023.
Quoted by Liberation, Jérôme Martin, co-founder of the Observatory of transparency in drug policies, also makes a link between the situation of French tension and American threats: “The concentration of production makes production itself a little more vulnerable. even, as much in the face of industrial problems as in the face of threats from anti-abortion lobbies. If you have diverse sites, calls for boycotts or threats are possible, but you have more possibilities to resist. There, with only one laboratory producing, we further weaken access to this technique. »
In a press release, the High Council for Equality between Women and Men (HCE) confirms the link with the recent announcement of the suspension of the marketing authorization in the United States of mifepristone (RU 486 ), one of the two components of the abortion pill used for medical abortions. “The US situation poses the threat of a shortage linked to the constitution of stocks by the American States which seek to compensate for a possible cessation of production and/or marketing of mifepristone and misoprostol. Another risk is a sharp increase in prices, due to possible production and supply disruptions. »
A situation far from trivial since in France around 70% of abortions are medicated. As a result, “access to abortion risks being severely restricted, seriously undermining women’s sexual and reproductive rights”, warns the HCE.
To overcome this supply difficulty, the Nordic Pharma laboratory offers an alternative imported from its Italian subsidiary. This is MisoOne 400 micrograms. “This specialty has the same level of quality and the same indications as the specialty marketed in France. It has the same misoprostol concentration, 400 micrograms,” the lab points out.
The National Agency for the Safety of Medicines and Health Products also claims to have put in place a “quota” to “best manage the stocks” available, with a ban on the sale and export of these drugs abroad.