essential medicines > note n°10

How to imagine the production and the consumption of essential medicines ?

We know that the production and the extensive prescription of essential medicine (EM) is not a utopia because it exists in Sweden. We also know that Sweden is not a country identical to France. It is a commonness to notice it. It would be an error not to list, for the use of EM, what is close in Sweden and in France and what separates both countries. On the way, it would be counterproductive not to envisage from now on the institution of EM in France, without making the effort to widen the project in Europe. By thinking for example of establishing a European cooperation agreement for the production and the consumption of EM.

But let us not go too fast, let us be realistic. Grasp all, lose all. How can we implant the EM on the market dominated by the multinational pharmaceutical firms? It is the major question that it is not too early to put. Can being it has diverse options there calling to choose one or several of them. We shall propose only one, hoping that among our readers there will be, imaginative and pragmatic, who will know how to draw another way of making.

Let us see the immediate offer. To begin let us satisfy we to establish a company of the united, social and non-profit economy, capable of managing a cooperative of purchase and distribution, centered on the list of EM, as soon as it will have reached the level of necessary maturity, to actually meet the needs of the great majority of the patients and of the prescribers. Other formulae can be envisaged. But the only ones who would not suit would be the ones who would give the priority to the commercial and financial objectives. By giving priority to the health of the patients and the population, the concept becomes EM founding of a model different from fashionable models: blockbusters and niche busters, the logic of which is to maximize the return on investment for the shareholders. One could add: although it costs it besides.

By using the list of EM, we can reasonably expect a decrease of the total consumption of prescribed medicines. Would thus the effort of promotion has to incite the doctors to prescribe fewer medicines by order, to reduce the ratio count of prescriptions/number of consultations, to keep the duration of every prescription in the optimal time. What will have for consequence a reduction of the global consumption in the country. From now on it is necessary to wonder about the likely consequences on the employment in this industrial sector. This aspect of EM must be considered. But it would be criminal in the name of financial interests or in the name of corporatist interests or both, to claim to defend against the health of the citizens the excessive consumption, responsible too often of a greater morbidity and/or of a greater mortality. In a future note, we shall come back in a more precise way on the means to envisage without further delay to prevent unemployments.

Dr Jean-Claude Salomon
February, 2015