France will produce its paracetamol: what impact in Switzerland?

The Covid pandemic has revealed the extent to which Europe depends on Asia for its supply of medicines. France has therefore decided to completely repatriate the production of analgesics to its territory.

Pascal Michel / ch media

Paracetamol or ibuprofen? The choice of analgesic reveals cultural differences. The first is very popular in Switzerland. Last year, health insurance companies paid a total of 430 million for painkillers, including 56 million for paracetamol-based items, such as Dafalgan.

This active ingredient is even more popular in France, where it is systematically found in family pharmacies. Our neighbors buy 538 million boxes per year. The situation is very different in Germany, where the best-selling drug remains ibuprofen.

We understood during the pandemic to what extent these national preferences in terms of remedies were anchored. At the start of the health crisis, the French Minister of Health recommended on Twitter not to swallow ibuprofen in the event of illness, as it could constitute “a factor in aggravating the infection”. He justified himself by explaining that ibuprofen is more effective against inflammation than paracetamol.

But this argument was later shown to be false. No matter, the authorities’ announcement had its full effect: in spring 2020, the French bought even more paracetamol. And to avoid a collapse in supplies, it was necessary to limit it to two boxes per person.

Two years later, when the mask requirement had been lifted and all kinds of pathogens had been released again, the supply situation remained precarious. There was still a shortage of painkillers, especially in the form of syrup for children. In Switzerland too, there were sometimes shortages. The situation has improved somewhat in our country since then. But the situation could quickly get worse again as the season of colds and other colds approaches.

While Berne uses mandatory reserves to avoid shortages, President Emmanuel Macron has chosen another path. He had already announced during the pandemic that he would bring back the production of paracetamol on his soil. It should again be manufactured in France, from the active ingredient to the packaging, from 2026. Currently, the basis of the drug, a white and crystalline powder, comes mainly from China and India. This creates a strong dependence on these countries. In a crisis, they will favor their own population, as we have seen recently. Europe will only have the crumbs.

Price drop to the trap

The Upsa pharmaceutical laboratory plays a central role in Macron’s “health sovereignty” plan. It produces 450 million packages of its flagship drug Dafalgan each year in the south, in Agen. With raw material imported mainly from the United States, India and China. This should change soon. The French state is investing 120 million euros in a new paracetamol factory in Rousillon, in collaboration with the firms Upsa, Sanofi and Sequens. In addition, Paris renounces a price reduction for two years. Today, a box of Dafalgan costs 2.18 euros in pharmacies. The manufacturer receives 76 cents.

Switzerland could benefit from this relocation to Europe. In our country toowe appreciate the red and white boxes, among the best-selling analgesics. However, the pressure on prices is massive. The Federal Office of Public Health (OFSP) monitors this regularly and pushes for a reduction – for the good of the insured. But this causes a side effect: the pharmaceutical industry ends up giving up producing a remedy when it no longer generates sufficient income. In Switzerland, a box of 30 Dafalgan tablets (500 mg) costs 11.60 francs in pharmacies. Only 2.19 francs end up in the manufacturer’s pocket. For children’s syrup, this amount is even only 1.38 francs.

“We no longer earn anything,” Patrick Leimgruber, head of Upsa Switzerland, tells CH Media. According to him, continuing to reduce the prices of critical references like Dafalgan is not without risk. Already today, manufacturers have to spend money. “If the situation persists, painkillers may even disappear from the futures market despite strong demand.” The executive emphasizes that his company is committed to supplying Switzerland in accordance with its needs. But that doesn’t always work, as a glance through hospital pharmacist Enea Martinelli’s database shows. Since Covid, there are regular shortages of certain types of Dafalgan.

The Federal Council ended up hearing the pharma’s calls for help. To secure supplies, the government has recently ordered various measures: in addition to import facilities and an extension of mandatory reserves, it intends to put an end to the low-tariff policy. Concretely, the executive must obtain the competence to define critical drugs, then excluded from waves of price reductions. Parliament is currently considering this change to the law.

Patrick Leimgruber welcomes these initiatives. As is the idea of ​​entering into “capacity contracts” with manufacturers. The Confederation would thus commit to purchasing predefined quantities. In return, manufacturers guarantee delivery.

Intervenes to businesses

The Federal Council will certainly much closer than Emmanuel Macron’s relocation plans or the demand from the Swiss Socialist Party to nationalize the generic giant Sandoz. It would cost billions. But Berne can undoubtedly move from words to action more quickly, and at lower cost.

Because French policy cannot counteract the forces of global markets either. This was recently shown in an announcement from the second major French producer of paracetamol, Sanofi. The group wishes to sell the majority of its Opella division, which produces, among other things, Doliprane, to an American investment fund.

This project fuels fears of relocation for the famous tablet. For security reasons, Emmanuel Macron has already imposed conditions on the transaction and bought the company with public funds of around 150 million euros. All this so that the French can still find their dear paracetamol at the pharmacy.

The news in Switzerland is here

(Translated and adapted by Valentine Zenker)