I’ve written before (here and here) about an alarming trend — shortages in hospitals of important, sometimes life-saving medications. The problem is most acute for drugs we inject into the body rather than pills. The Food and Drug Administration (FDA) keeps a list of drugs in short supply; it is long and getting longer. Things aren’t getting better; they’re getting worse. The items on the list now number in the hundreds. The list changes so frequently from day to day that hospitals scramble with a real-time way of keeping track.
Just yesterday I learned that chloral hydrate, an old, old medicine, will not be made anymore. The one company making it has decided to stop. Although it’s an old drug, chloral hydrate still has an important place in the toolkit of doctors like me who sedate infants and small children for procedures. Now we won’t have it anymore. Why do we have these shortages? What’s going on?
The problem is that the drugs in short supply are virtually all generic, off patent. They are cheap. So the profit margins for the manufacturer is slim. A drug company can make much, much more money by looking for yet another “me too” drug we don’t need. The old standby drugs, the injectable ones we need everyday, are cast aside. A related problem is that, for many of these drugs we still can get, only one factory makes them. So if there’s a problem at the factory, there is an instant nation-wide shortage.
What’s the solution? I see no other way than for some federal authority to subsidize the production of these medicines in a way that allows the companies making them to make a reasonable profit. The totally free market got us into this mess, and it won’t get us out. If anything, it will get worse.
10/19/2011 • When most people go into the hospital it does not occur to them that, here in America, an acute scarcity of a standard medication will affect their health. But they would be wrong. Sudden, random, ...more
Still another reason your insurance premiums go up: cost-shifting from public to private payers is getting worse and worse
10/24/2011 • A recent editorial in the New England Journal of Medicine makes an interesting contrast between the approaches public and private health plans have taken in controlling costs. It points out how governmental health programs -- ...more
10/21/2009 • Last week there was a notice in my mailbox from the pharmacy telling me that an antibiotic intensivists use frequently, vancomycin, was in extremely short supply. We still have some, but we were instructed to ...more
12/01/2010 • No pediatrician I know has ever liked any of the many over-the-counter cough and cold remedies very much, especially for very young children. There never has been any evidence that they help cold symptoms, and ...more
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02/19/2013 • Shortages of a long list of medications have been a problem for some time now. Many, many important drugs are in short supply. The FDA even keeps a list of them. The reasons for this ...more
12/15/2012 • This little cartoon, courtesy of xkcd, highlights a problem we have had for some time, but which is getting worse--highly antibiotic-resistant bacteria. Soon after the first antibiotics appeared, especially penicillin, doctors noticed the phenomenon of ...more
02/19/2012 • I've written before about how the current standard of care is to provide some sort of sedation drugs -- by mouth or by injection -- to relieve pain and anxiety when we have to do ...more
01/22/2012 • Open most any medical journal, including the most prestigious of them, such as the New England Journal of Medicine, and you will see page upon page of glossy advertisements from drug companies for their products. This ...more