When you re brought into an emergency room following an auto accident and there isn t enough IV saline to go around, you re not going to care all that much why. And if you re not in too much pain (because they may be out of morphine too), perhaps you ll ponder why we should even have to worry about these things.
Unfortunately, not only is this the case, but it may be getting worse.
According to a story in today s New York Times, it s mighty ugly in hospitals right now. The continuing shortage of low profit, injectable sterile drugs something that has been in the news for years continues to threaten lives, yet there is still no viable plan to address the problem.
Although President Obama issued an executive order in 2011 requiring manufacturers to notify the FDA of anticipated shortages and discontinuations, companies cannot be forced to make anything, so it is far from clear how this gets resolved.
Multiple factors have been cited as contributors to the crisis: Lack of financial incentives for generic manufacturers, price controls on these drugs established by Congress in 2003, quality control problems during manufacturing, and outdated manufacturing facilities. Regardless of the reason, the bottom line is pathetic In the US in 2014 we don t have enough saline solution to go around.
Also in short supply: chemotherapy drugs, glucose, intravenous nutrients, sedatives, anti-nausea medicine. And many more.
Phil Zweig, executive director of Physicians Against Drug Shortages, is quite clear about where he believes the blame lies: "The only way to end the inexcusable travesty of drug shortages is to address the real root cause: anticompetitive group purchasing contracting practices and self-dealing, which have undermined the economics of this marketplace. And the only way to do that is for Congress to repeal the 1987 Medicare anti-kickback safe harbor, which exempted GPOs from criminal penalties for taking kickbacks from vendors."
ACSH s Dr. Josh Bloom gave us a heads up about this back in 2011. His New York Post op-ed entitled Running out of Common Drugs painted a very bleak picture of the situation. Two and a half years later it is still bleak.