PLFSS 2027 bill raises antibiotic dispensation debate

The PLFSS 2027 funding bill has reignited discussions about the unit dispensation of antibiotics, a system that would require pharmacists to dispense only the exact number of units prescribed for specific antibiotic treatments. This could mean opening industrial packaging to provide the precise number of pills or doses needed for the full course of treatment.

Economic concerns from Court of Audit

The Court of Audit has highlighted economic concerns, suggesting the impact on health spending would be minimal, given the costs pharmacists would face in implementing the system. The audit also noted that the financial burden on pharmacies could outweigh any potential benefits.

Pharmaceutical union opposes the measure

The Union of French Pharmacists (USPO), represented by its president Pierre-Olivier Variot, opposes the unit dispensation, warning of operational and economic challenges for pharmacies. The union points to past concerns raised in March 2025, including difficulties with medicine traceability, re-packaging costs, and the need for additional documentation and secure packaging.

USPO calls the device a "gadget"

The USPO criticizes the unit dispensation as a "gadget" that has not been adequately evaluated. While acknowledging the importance of combating antibiotic resistance, the union argues that the measure should not be generalized without proof of its effectiveness or consideration of its economic and organizational impact.

FSPF also opposes the unit dispensation

The French Society of Pharmacists (FSPF), represented by its president Fabrice Camaioni, opposes the unit dispensation, calling it a "false good idea." Instead, the FSPF favors adapting packaging to better match prescriptions and respecting medical recommendations.

USPO proposes alternative measures

Rather than enforcing the de-packaging of antibiotics, the USPO suggests three areas of focus: re-evaluating the number of units in industrial packaging with the National Agency for Medicines and Health Products Safety (ANSM), creating a working group to improve communication between doctors and pharmacists, and enhancing patient information to improve adherence to prescribed treatment durations.

USPO advocates for targeted use

The USPO supports a strategy based on proper antibiotic use and adapting practices rather than enforcing strict unit dispensation. It previously supported using the system only in specific public health situations, such as shortages or for high-risk medications, and prefers a more flexible approach to reduce waste.

PLFSS 2027 aims to manage antibiotic use

Article 28 of the PLFSS 2027 bill seeks to reduce unnecessary antibiotic use and ensure the availability of essential medications by introducing financial compensation for drugs with low sales. The bill also allows for the regulation of certain antibiotic prescriptions in telemedicine, aiming to balance public health goals with practical implementation.