Epilepsy Talk

The Deadly Drug Shortage — An Escalating Crisis | February 28, 2016

It’s not just “what if”. The drug shortage has become so severe that you can even go to an index to find your drug and its probable shortage.

Even the US Library of Medicine has cited the continuing “Drug Shortage Crisis in the United States”.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278171/

The New York Times talks about “Drug Shortages Forcing Hard Decisions on Rationing Treatments.”

http://www.nytimes.com/2016/01/29/us/drug-shortages-forcing-hard-decisions-on-rationing-treatments.html

Fortune Magazines has the headline: “The U.S. has a drug shortage — and people are dying”.

http://fortune.com/2015/01/06/the-u-s-has-a-drug-shortage-and-people-are-dying/

And the Wall Street Journal cites “U.S. Drug Shortages Frustrate Doctors, Patients.”

http://www.wsj.com/articles/u-s-drug-shortages-frustrate-doctors-patients-1433125793

You can even find drug shortages – by generic drug name or shortage list

http://www.ashp.org/shortages    http://www.ashp.org/menu/DrugShortages/CurrentShortages

This is not a new problem, but rather an ongoing problem that worsens every year.

In recent years, shortages of all sorts of drugs — anesthetics, painkillers, antibiotics, cancer treatments — have become the new normal in American medicine.

The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drug makers abandoning low-profit products.

But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public.

More than half of the drugs on the shortage list are considered critical — meaning they have no alternative. The drugs most often in short supply include chemotherapy drugs for cancer, antibiotics for severe infections and anesthetics for surgery.

Some of the drugs on the list, such as the amphetamine mixed salts used to treat ADHD or attention-deficit and hyperactivity disorder, have been on the list for a year or more.

It’s even come down to rationing as a means of addressing the shortage, which health care workers say has ceased to be a temporary emergency and is now a fact of life.

In desperation, they are resorting to treating patients with less effective alternative medicines and using expired drugs.

Drug shortages have numerous implications for hospitals, healthcare providers and patients.

These include adversely affecting choices for drug therapy, delaying medication therapies or treatments, escalating costs of product and resources to manage shortages, and increasing risk for medication errors and potentially fatal patient outcomes.

Besides the lack of effective drug treatment, many other areas of medical care can be impacted, including medical procedure delays, treatment protocol delays, rates of medication errors, patient health outcomes, and cost.

There’s also an emotional component to the drug shortages of frustration, anger, anxiety, and mistrust that results in strained relationships between the providers and manufacturers, pharmacy and prescribers, patients and providers.

It’s come down to health care workers around the country using expired drugs or less effective alternatives when a critical medicine can’t be found. The shortages of generic drugs also drive up the cost of care when doctors have to use a more expensive drug instead.

“When you can’t treat basic things — cardiac arrest, pain management, seizures — you’re in trouble,” said Dr. Carol Cunningham, the state medical director for the Ohio Department of Public Safety’s emergency services division.

“When you only have five tools in your toolbox and three of them are gone, what do you do?”

And the scary news is: that these drug shortages have forced the F.D.A. to make some tough choices.

Like allowing manufacturers to sell drugs that most likely would have been recalled if it were not for the crisis.

Even intravenous saline solution, a hospital staple, has been in short supply, leading some hospitals to ration their use. An American Hospital Association survey found that almost every U.S. hospital has faced a lack of basic medicine.  Many have even hired a full-time staff person specifically to navigate shortages.

Hospitals have developed complex formulas to help ration existing drug supplies—essentially, to determine which patients get medication and which don’t.

“No doctor wants to prioritize,” says Richard Schilsky, MD, chief medical officer of the American Society of Clinical Oncology. “But if you have five patients and only three vials, that’s a very real problem.”

 

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Resources:

http://www.nytimes.com/2016/01/29/us/drug-shortages-forcing-hard-decisions-on-rationing-treatments.html

http://www.rd.com/health/conditions/drug-shortages/

http://www.drugs.com/drug-shortages/http://www.apsf.org/newsletters/html/2012/spring/04_shortage.htm   http://www.cnn.com/2012/07/25/health/fda-drug-shortages/index.html

http://vitals.nbcnews.com/_news/2012/09/07/13707466-drug-shortages-down-overall-but-some-linger-longer?lite

http://www.businessweek.com/articles/2012-10-25/bloomberg-view-the-hidden-dangers-of-drug-shortages

http://www.nytimes.com/2012/11/26/opinion/a-stubborn-drug-shortage.html?src=recg&_r=0

http://www.nytimes.com/2012/11/17/business/drug-shortages-are-becoming-persistent-in-us.html?pagewanted=all

 


13 Comments »

  1. Are there any AEDs on this list?

    Like

    Comment by Martha — February 28, 2016 @ 10:42 AM

  2. Take a look at http://www.ashp.org/shortages http://www.ashp.org/menu/DrugShortages/CurrentShortages and key in your particular med.

    Like

    Comment by Phylis Feiner Johnson — February 28, 2016 @ 10:47 AM

  3. There are many times I go in to refill my migraine pain med and it has to ordered; they never have it or they never have the full supply and I’m not talking about a lot of pills either!

    I also, at times, have the same problem with my AEDs. It has become very scary to not know whether or not I will be able to get what I need. In fact, my old, very reliable pharmacy is unable to fill my prescriptions anymore as they told me they can not get the meds I need and told me I have to go to one of the chain stores like a CVS. The only problem with this is when relying on generic meds to keep the cost down, one doesn’t know which company the generic med is coming from. AEDs should remain consistent or it can cause a problem for the patient and at least with my old pharmacy I knew I was getting the same generic…now I don’t and I just have to deal with it. Sometimes the results of just dealing with it are not fun at all. I wish those in the pharmaceutical industry who make this stuff would get that…

    Like

    Comment by Janet — February 28, 2016 @ 4:01 PM

    • Janet, I too have found, for some mysterious reason, that CVS often has the drugs in stock that other places (even Walgreens) doesn’t.

      As far as generics, they tell you to look at the size, shape and color of the pill to make sure you’re getting the same thing. FAT CHANCE. I’m lucky if they have it at all.

      And since generics are 80% formulary and 20% “filler”, there’s no promise of any consistency at all.

      So, it’s a crap shoot in a number of ways.

      Ain’t meds great? 😦

      Like

      Comment by Phylis Feiner Johnson — February 29, 2016 @ 10:05 AM

  4. That’s why I’ve been searching alternative med for my child since she was diagnosed. I know there are alternatives to just popping pills. Her neurologist always reprimands me for searching too many alternatives. But I’m happy I did, because she is now doing well with homeopathy with a very good homeopath. Fingers crossed we will reduce her meds soon, albeit slowly…She had just started with homeopathic treatment less than 2 wks ago! ..There’s alternative folks, just don’t give up on finding them…

    Like

    Comment by jane — February 28, 2016 @ 10:08 PM

  5. Isn’t it strange that there is a shortage of legitimate medications, but an “epidemic” of cocaine and heroin?

    Like

    Comment by Martha — February 29, 2016 @ 10:11 AM

  6. More ambitious resources! 🙂

    Like

    Comment by Phylis Feiner Johnson — February 29, 2016 @ 10:13 AM

  7. Thanks for the list Phylis, glad to see my drug, gabapentin is not on it. The original makes of the generic i was on, they stopped making it, so i was switched to another manufacturer, and good God my stomach started hurting during the day and normally after i took the pill. So i told my pharmacy at Kaiser to give me a different brand. They did and this one was soooo much better. No more stomach pains. That’s the beauty of being on one meds, if something fells weird or not right, it’s probably the pills. MY advise, never hesitate to speak up if something is not right. Don’t be a hero and think you can handle the pain, it could do damage.

    Like

    Comment by Zolt — February 29, 2016 @ 4:21 PM

  8. Zolt, Glad that you were able to get a different brand of Gabapentin and ease your suffering stomach.

    The problem is, so many people DO suffer in silence. They think this is the way it’s supposed to be.

    And BIG Pharma doesn’t help, either. 😦

    Like

    Comment by Phylis Feiner Johnson — February 29, 2016 @ 5:37 PM

  9. Hi everyone. I’m 16 and I often feel empty, sad and I don’t really have any motivation for anything (which affects my work and concentration at school), at my age I think I should maybe feel a little more “full of life”. When I am sad, I always listen to sad songs and think about all the thing that are wrong in my life.. like to make me even sadder. Sometimes I even choose the saddest song I know just to make me cry. I feel like I’ve gotten used to being sad and tired all the time, and I even think I might like crying.. Could this be a depression, or a form of mental self harm, or maybe just something some teenagers go through?

    Like

    Comment by Petrovich — April 25, 2016 @ 4:01 PM

  10. I would call it depression. (But stop with the sad songs, they’re just getting you deeper into the depression hole.)

    Rather than calling it clinical depression, I would call it “situational” depression.

    First, of all, being a teenager is no day at the beach. And then are there are the raging hormones coursing through your body.

    You might ask your Personal Care Physician to recommend a therapist. There’s no shame in that. I’ve been in therapy for umpteen years and that (along with antidepressants) has done me a world of good.

    Here’s hoping you find your way to the top real soon!

    Like

    Comment by Phylis Feiner Johnson — April 25, 2016 @ 5:02 PM


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    About the author

    Phylis Feiner Johnson

    Phylis Feiner Johnson

    I've been a professional copywriter for over 35 years. I also had epilepsy for decades. My mission is advocacy; to increase education, awareness and funding for epilepsy research. Together, we can make a huge difference. If not changing the world, at least helping each other, with wisdom, compassion and sharing.

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