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Pfizer recently announced that it was restricting the sale of seven drugs used in lethal injections, saying it objects to the use of its medicines for the purpose of capital punishment. On the surface, you might think that the company is a trailblazer in taking a stance on this very emotionally-charged, long-running issue. But I don't buy it. It is possible that the announcement is little more than a public relations stunt. First of all, the company isn't blazing any trails. Pfizer, one of the world's largest pharmaceutical companies, is actually the last of more than two dozen pharmaceutical companies that have already instituted such a policy. Second, these seven drugs are not just used for lethal injection. They are used in hospitals, mostly for surgery. Here is a list and the purpose for each: Propofol: Anesthesia and sedation. Also used for procedures such as colonoscopies. Midazolam (aka Versed): Sedation, often preoperative. Potassium chloride: Electrolyte. Pancuronium bromide, rocuronium bromide and vecuronium bromide: Muscle relaxants used during surgery and intubation. Hydromorphone (aka Dilaudid): The strongest of the opiate (derived from poppy) drugs. About five-times more potent than morphine. Third, they are already on the list of drugs in short supply, which is kept by the American Society of Health‑System Pharmacists. The shortage of common hospital drugs, which I described in the New York Post in 2011, is itself a crisis and has resulted in multiple deaths and medical incidents. The FDA maintains a list of mishaps that are caused by drug shortages. It is not pretty. In one case, an anesthesia drug that was in short supply was being rationed by a hospital. The patient, who was given too little of the drug, awoke during surgery. In another hospital, IV sedatives were running low so they were parceled out carefully. Too carefully. An intubated woman who was not sufficiently sedated bit half off her tongue off while trying to remove the tube from her throat. What were the two drugs that were in short supply? Propofol and midazolam, which are now on the list of Pfizer's restricted drugs. The fact that all seven drugs were, or are, in short supply raises two intriguing questions: 1) Has Pfizer actually been making these drugs, or are they "stopping" something that they weren't doing anyhow? 2) If they have been making them, why the shortage? The company's new restrictions will make it more difficult for states to obtain drugs for lethal injection, but will also make it more difficult (or at least more time consuming) for hospitals to purchase them. Will this exacerbate an already-appalling situation, where hospitals are scrambling to keep in stock some of the most basic, essential drugs that are found in every emergency room in every hospital? It is possible that Pfizer's proclamation last week is founded on principle. But it's also possible that Pfizer's image, which recently took a big hit when it attempted to merge with Allergan to avoid paying more than $20 billion in U.S. taxes, is really what is behind this. What do you think?
