published Monday, November 14th, 2011

Drug shortage threatens lives

A persistent shortage of many prescription drugs, especially some widely used antibiotics, chemotherapy drugs and medicines often employed to save lives in emergency rooms, is causing growing alarm among doctors and their patients. The problem is not new, but it is growing worse and beginning to adversely affect the treatment and even survival of patients. Broad-based efforts to remedy the problem are underway, but there is no quick answer at hand.

The Food and Drug Administration maintains a list of what it terms "medically important" drugs that are in short supply. Currently, the agency reports that about 180 prescription medicines are in short supply. A majority on the list are hard-to-manufacture, often injectable, generic formulations that require considerable effort to be kept sterile. As a result, many manufacturers have stopped producing the cheaper, generic, opting instead to manufacture far more profitable branded drugs.

The result is predictable.

A June survey by the American Hospital Association of 820 members found that almost all had experienced a shortage of at least one vital drug in the previous six months and that about half had shortages of 21 or more prescription medications. Those shortages, the report indicated, forced hospitals and physicians to delay needed treatments, to provide patients with less effective drugs or, in worst case scenarios, to ration the use of drugs. Such restrictions, public and private health experts report, have harmed patients.

The reason for the shortages are hard to pinpoint, but market contractions that reduced the number of generic drug makers, shortages of ingredients and contamination issues at several facilities are likely culprits. Those problems will be difficult to correct in the short term.

Long term solutions are possible, though. President Barrack Obama recently signed an executive order that allows the FDA to address the problem. That won't restore the flow of vital drugs to the nation's hospitals but it is a first step.

Other help is needed, including government-supported programs to stockpile needed drugs and to promote manufacture of useful generics. Those problems likely will require increased federal oversight of the pharmaceutical industry. Many within the industry will find that objectionable, but those objections are more self-serving than useful as the nation works to create a system that delivers a steady stream of life-sustaining drugs to Americans who need them.

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