Monday, December 18, 2017
Opinion

Drug shortage disasters await

I am not an expert on health-care delivery, but I know enough to realize that having insurance does not equate to obtaining adequate health care.

I witness daily the devastating effects of nationwide prescription drug shortages while trying to provide prudent health care to hospitalized patients. This happens if the patient has excellent insurance coverage or can afford to write a big check for proper care.

Unfortunately some of these shortages have involved intravenous sterile medications for treatment of life-threatening conditions in a critical care setting, sometimes without an adequate alternate choice.

The United States government is aware that the prescription drug shortages nearly tripled between 2005 and 2010 and shortages are becoming more severe and more frequent in spite of President Obama's October 2011 executive order to address the problem and the resulting actions from the Food and Drug Administration.

People may understandably assume that the real reason for the shortage is corporate greed. Even though the manufacturers are in the business to make a profit, most of the time the shortage is because of an unprepared and unexpected imbalance between supply and demand. Price gouging is mostly the result of a shortage (through secondary markets) rather than the reason for the shortage. Unlike other industries (for example gasoline) the consumption of necessary medications cannot decrease in proportion to reduced supplies or increased prices.

Real causes for prescription drug shortage can be many: Manufacturing problems, including regulatory actions for maintenance of quality; production delays including shortage of raw materials or components; increased demand; distribution disruptions and corporate decisions to discontinue the product line. For example, the patent runs out for the brand name and the generic industry works with very low profit margins and cannot accommodate the market variations.

Also, for the manufacturer, there is no penalty for producing too little of a prescription drug, but there is potentially a high cost for producing too much of the drug because of a relatively limited shelf life. In these circumstances, the distributors are also protected from penalties of failure to supply.

Irrespective of the cause, the prescription drug shortage is as significant and life threatening as any other public health problem. Most of the time it is unrecognized by the public and it deserves the concerted attention and concentrated action of the government to influence the pharmaceutical industry in several positive and preemptive ways, without compromises in the quality and cost.

That should not be a big challenge for our government, which accomplished a similar goal in the past with vaccines.

We the people have elected members of Congress to comfort and protect our lives. Will they?

You have a right to ask. Will you?

Dr. Rao Musunuru is a Bayonet Point cardiologist.

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