Epilepsy Talk

The deadly drug shortage — an escalating crisis | October 29, 2022

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 specific drug shortages, published here:

https://www.drugs.com/drug-shortages/

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

https://www.upi.com/Health_News/2022/09/16/drug-shortages-lorazepam-cancer/6681663190912/

http://www.drugs.com/drug-shortages/

https://www.fda.gov/drugs/drug-shortages/search-list-extended-use-dates-assist-drug-shortages

http://www.cnn.com/2012/07/25/health/fda-drug-shortages/index.htm

lhttps://prosperousamerica.org/fdas-updated-drug-shortage-list-loaded-with-critical-medicines/

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

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