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Position Paper: MLPS call for the drop of the pilot introducing ePI in order to:

  • Ensure that all citizens, especially the elderly and the digitally excluded, have access to vital medical information.

  • Preserve the paper record industry and support employment in this crucial sector.

  • Take account of the environmental and ethical risks of a 100% digital approach.

1. Endangering patient safety: The digital divide

Eliminating paper medical information leaflets poses significant risks to patient safety, especially for older adults and those without digital access. Many elderly individuals and non-digitalised populations rely on these paper leaflets for crucial information about their medications. Without them, they may struggle to obtain necessary details about dosages, side effects, and interactions, potentially leading to misuse and health complications. This change could disproportionately affect those who are already vulnerable, exacerbate health disparities and increase the risk of medication errors.

  • Digital Illiteracy Among the Elderly: 62% of individuals aged 75 and above are digitally illiterate, and only 36% own a smartphone. [1]

  • Widespread Digital Illiteracy: 8 million people in France lack basic digital skills. [2]

  • Accessibility Challenges: Those with severe disabilities, living in internet-free areas (12% of the French population [3] or unable to afford or use smartphones will lose equitable access to vital medical information. According to INSEE, access to technology correlates with income, with smartphone ownership ranging from 65% to 95% based on living standards.

2. Aggravating Social Isolation and Age Discrimination

The digital divide reinforces the social isolation of older people by limiting their access to information and social activities. Many older people lack digital skills, and this can lead to feelings of exclusion and loneliness.

  • Digital Exclusion and Age: The Défenseur des droits' report highlights that older individuals face greater challenges with digital technology and online administrative tasks. 22% of people over 85 abandon tasks when facing difficulties, compared to 14% of those aged 65-85 [4].

  • Severe Dependence: Severely dependent individuals are seven times more likely to give up on digital procedures. Nearly half of those aged 70+ are concerned about e-administration.

  • Age Discrimination: 17% of people aged 65+ have experienced age discrimination in the past five years. The COVID-19 crisis has exacerbated feelings of isolation and discrimination, with 25% of elderly individuals feeling isolated and 10% feeling discriminated against [5].

3. Threatening Jobs and Local Economies

The switch to 100% ePI is threatening the French paper leaflet industry. This project could lead to a major economic slowdown in the sector, affecting the companies and professions that depend on it. The industry faces an uncertain future as demand for its products declines.

  • Impact on industry: The sector, which is vital to several French companies (Groupe Tonnellier, Papeterie des Vosges, LGR Packaging, etc. , has employed thousands of people and supported entire communities since the 19th century.

  • Job losses: The paper and board industry has already lost nearly 20,000 jobs between 2005 and 2020. With job losses slowing, the sector retains significant growth potential, with investment currently on hold due to the uncertainty surrounding this pilot project.

  • Re-industrialisation objectives: In line with the political ambitions for re-industrialisation that have been deployed for decades, MLPS is calling for continued support for existing industries and encouragement of new investment in France in a historic industry.

4. Raising Sustainability and Data Privacy Concerns

Digital technologies are raising serious concerns in terms of sustainable development and ethics. The energy consumption of digital devices and data centres poses environmental problems. From an ethical point of view, the digital switchover can exclude those who do not have access to this type of technology. There are also problems of data confidentiality.

  • Environmental impact: Digital devices and data centers consume a lot of energy and produce electronic waste. Paper records are highly recyclable and European forests, the main source of raw material, have grown by 9% over the last 30 years. Their surface area is greater than it was 100 years ago [6].

  • Lack of transparency: Transparency regarding the environmental impact of digital solutions is sorely lacking. Data on the carbon footprint of digital platforms is often inaccessible, despite requests for access to measure the carbon footprint of different solutions.

  • Data confidentiality and cyber risk: the security and use of patient data accessible via the ePI are unclear. Without guarantees of confidentiality, patients should be able to access medical information offline in a secure manner. In addition, digital solutions are vulnerable to cyber-attacks. This could lead to serious health risks, particularly in emergency situations where rapid access to drug information is crucial.

[1] 94% des 15-29 ans ont un smartphone en 2021, 2021, INSEE, disponible ici.

[2] Huit millions de personnes en situation d’illectronisme en France, 2024, Observatoire des inégalités, disponible ici.

[3] 15% des Français peinent à utiliser Internet, 2023, Les Echos, disponible ici.

[4] Rapport officiel : Difficultés d’accès aux droits et discriminations liées à l’âge avancé, Défenseur des Droits, 2021, disponible ici.

[5] Rapport officiel : Difficultés d’accès aux droits et discriminations liées à l’âge avancé, Défenseur des Droits, 2021, disponible ici.

[6] Rapport officiel : Comment les forêts européennes ont-elles évolué au cours des 30 dernières années ?, Commission Européenne, 2021, disponible ici.


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