Age and sex disparities in drug shortage impacts: a 10-year nationwide study in France

TL;DR

This study shows that drug shortages in France disproportionately affect older adults and women, highlighting health inequalities.

Contribution

The study provides the first nationwide analysis of age and sex disparities in drug shortage impacts over a 10-year period.

Findings

Older patients (≥60 years) were more affected by most therapeutic classes during drug shortages.

Women had higher exposure to drug shortages across all major therapeutic categories.

Younger patients and men showed higher use of specific drug classes like anti-infectives and renin–angiotensin agents.

Abstract

Drug shortages are a growing public health issue, unevenly impacting therapeutic classes. Despite variations in drug consumption across populations, the consequences of these shortages on different patient groups remain insufficiently characterized. This study investigated age and sex profiles of patients consuming the therapeutic classes most commonly affected by drug shortages in France. The age and sex risk of shortage exposure were estimated in a nationwide retrospective study of French patients between 2014 and 2023, using data from the French drug shortage notification system and the national health insurance for the entire French population. Over 10 years, 17 505 drug shortage reports were recorded, 60.8% involving cardiovascular, nervous system, and anti-infective agents. Significantly higher mean percentages of consumers for drugs concerned by shortage reports per 1000 were observed in ≥60-year-old patients for 12 of the 14 therapeutic classes, compared to 20–59-year-old patients (P = .002). Younger population was more significantly concerned by anti-infective agents (11.2 vs 9.2, P = .002), respiratory system (1.8 vs 1.5, P = .002), and sensory organ (0.7 vs 0.6, P = .002) classes. Significantly higher mean percentages of consumers for drugs concerned by shortage reports per 1000 were observed for all Anatomical Therapeutic Chemical 1st level classes in women (P = .002), but agents acting on the renin–angiotensin system were higher for men (2.32 vs 2.02; P = .002). Our exploratory results suggest that a population-level approach is essential to understand how shortages affect different groups and exacerbate health inequalities.

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