Blog | Wednesday, October 5, 2011

QD: News Every Day--Drug shortages lead to treatment delays, death

Crucial drugs are running in short supply and patients are dying as a result.

Much of the problem stem from manufacturing problems that interrupt production. There may be only one or two companies making a drug, and when something happens such as contamination, it creates huge gaps. As a result, there's been 213 drug shortages so far this year, or two more than all of the previous year.

The shortages have forced hospitals to resort to gray market purchases. These involved third parties that may corner the market on some drugs, and resell them at exorbitant mark-ups. The practice then fuels further shortages.

And this "new" crisis has been occurring for a decade. ACP Internist ran an article 10 years ago that could run in its pages today. The article outlines how doctors were scrambling to find alternatives for everything from beta-blockers and fungicides to hard-to-find antibiotics. They faced interruptions from pharmacists delivering the bad news, and worried over controlling medical conditions such as hypertension because of switching drugs.

The article outlines what the FDA was doing 10 years ago, and it's similar to what the agency is doing today. The FDA compiles drug shortage information from the manufacturers, but that information is voluntarily provided, and the FDA isn't tasked with ensuring coverage. A bill, the Preserving Access to Life-Saving Medications Act, was introduced in Congress to force manufactures to notify the agency six months in advance if a shortage could occur. It's been in committee since February. [UPDATE: On Oct. 6, the AP reported that a U.S. House member investigating drug shortages is demanding that five distributors explain how they are getting their supplies, the markups they charge and thier executive compensation. And, there is now a tip line for complaints.]

In the meantime, patients are taking matters into their own hands. As ACP member Steven Tucker, MD, points out, cancer patients have taken to medical tourism to find the drugs they need.

Let us know how drug shortages have affected your practice, and what steps you take to handle it.