France has a highly structured and regulated system for distributing medicines. Whether you’re a pharmaceutical company planning to enter the French market or a healthcare professional aiming to navigate the supply chain more efficiently, understanding the different distribution channels and key players is essential. Here’s a clear and up-to-date overview.
A Robust and Regulated Infrastructure
There are approximately 950 pharmaceutical establishments in France, all authorized and regularly inspected by the ANSM (French National Agency for the Safety of Medicines and Health Products). These establishments handle the manufacturing, import, distribution, and sale of medicines across the country.
Key Stakeholders in Wholesale Distribution
Several major players are involved in the wholesale distribution of medicines in France:
- Manufacturers: They produce medicines and sell them either directly to pharmacies (retail and hospital) or to wholesale distributors.
- Exploitants: These entities hold the marketing authorization (MA) and are responsible for placing medicines on the French market. They may delegate logistics to depositaries.
- Depositaries: They manage logistics on behalf of pharmaceutical companies, mainly supplying hospital pharmacies (PUIs).
- Wholesale Distributors: These entities purchase medicines from manufacturers and primarily sell to community pharmacies.
- Pharmaceutical Purchasing Groups: Since 2009, retail pharmacies have been able to pool purchases of non-reimbursed medicines via centralized purchasing structures.
Distribution to Retail Pharmacies
Community pharmacies source around 80% of their medicines from wholesale distributors, who ensure rapid and broad access nationwide. The remaining 20% of medicines are purchased directly from manufacturers, exploitants, or depositaries. This diversified supply strategy helps ensure resilience in the event of shortages or urgent needs.
Online Medicine Sales: Strictly Regulated
Since 2013, online sales of non-prescription medicines are allowed in France under strict conditions. Only authorized retail pharmacies with approval from a Regional Health Agency (ARS) can operate an online pharmacy. These websites must display an official logo to guarantee legitimacy, quality, and patient safety. It’s essential to always verify the website’s authorization before purchasing.
Hospital and Care Facility Pharmacies (PUIs)
Unlike retail pharmacies, hospitals and medical-social establishments with PUIs (Pharmacies for Internal Use) purchase 95% of their medicines directly from manufacturers, exploitants, or depositaries, primarily through public procurement procedures in accordance with French public procurement law.
Only 5% of hospital pharmacy purchases are made through wholesale distributors, mostly for urgent needs or additional supplies not covered by tenders.
PUIs do not dispense medicines to the general public—only to hospitalized or resident patients. However, there is one important exception.
Hospital Outpatient Dispensing: The Retrocession Model
In the interest of public health, certain hospitals with PUIs are authorized by ARS to dispense specific medicines to non-hospitalized (outpatient) patients, a process called retrocession.
These retroceded medicines are listed by the Ministry of Health and include drugs with specific dispensing or monitoring requirements, such as:
- Blood-derived products
- Antiretrovirals
- Treatments for chronic hepatitis B or C
- Antibiotics and antifungals
- Orphan drugs
- Oncology medications
Retrocession ensures that high-risk or complex medicines are delivered in a controlled environment with the appropriate clinical oversight.
In Summary
France’s pharmaceutical distribution system is highly regulated and multi-layered, ensuring efficient, safe, and traceable access to medicines. For any company entering the French market, understanding this system is a crucial first step in building a successful go-to-market strategy.
At Elliogen, we support pharmaceutical companies in navigating the French regulatory and commercial landscape, especially when it comes to understanding the strategic role of the “exploitant”, a unique and essential actor in France.
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