OBJECTIVES:

Medicines shortages are an increasing concern preventing patients to get access to the needed treatment. Its number has been multiplied in France by 20 between 2008 and 2018. Antibiotics are particularly vulnerable notably those dispensed in hospitals.

This study aims at analysing potential impact of the hospital tendering and antibiotics’ availability in France.

METHODS:

The analysis compares the tendering methodology between antibiotics having faced shortages with antibiotics with a continuous supply. It is composed by two groups:

1/ The shortages group is composed of 25 antibiotics that were subject to shortages. They were extracted from the national shortages database.

2/ The control group is composed of 10 antibiotics that have not experienced supply discontinuity.

The tendering methodology was collected by three of the main hospital purchasing groups in France. They correspond to more than 70% of the French market in value. It included among others information on the type of procurement, contract duration and renewal, delivery time, award criteria, and inclusion of clauses.

RESULTS:

No major difference in tendering design was identified between the two groups. The analysis reveals that old-brand injectable antibiotics are particularly vulnerable to shortages.

There is limited data provided to national purchasing groups by the hospital when they execute the procurement contracts. Procurement among the shortages group corresponds to lower order volume and shortened contract duration. Contract awards rely in both groups mostly on price. The analysis reveals limited use of supply security clauses.

CONCLUSIONS:

The study does not identify any direct correlation between hospital tendering methodology and antibiotics shortages. Fostering tendering to include industrial planning could mitigate shortages.