Drive for profits causes drug shortages

All the major media are emitting worried noises over the shortages of medical drugs in the United States. The problem has been with us for the last seven years or so and is growing worse, according to the Food and Drug Administration, which began monitoring the shortages in 2004.

Almost all these drugs are generics, which means that the companies producing them can’t make the huge profits big pharmaceuticals make on the brand-name drugs they control.

Nobody knows how many people have been affected by the shortages and not even the FDA has firm figures. Drug companies may but are not obliged to tell the FDA when they stop producing a drug.

According to the FDA’s “Frequently Asked Questions” Web page, there were 178 shortages in 2010, “132 of which involved sterile injectable drugs” primarily used to combat cancer and for anesthesia. Some specialists with the American Cancer Society — both physicians and pharmacists — feel that the real number is closer to 400.

A survey of 820 hospitals by the American Hospital Association found that almost all have had at least one shortage in the past six months, while half had shortages of at least 21 drugs.

It’s hard to tell how these shortages affect patients. In many cases, there are alternative drugs; however, some are more expensive or less effective. Some patients can wait, but they are suffering.

Dr. Michael Link, president of the American Society of Clinical Oncology, was quoted as saying: “These shortages are just killing us. These drugs save lives, and it’s unconscionable that medicines that cost a couple of bucks a vial are unavailable.” (New York Times, Aug. 19)

The New York Times, the Washington Times and ABC-TV all present the causes of these shortages as complex, hard to unravel, not well documented.

According to Valerie Jensen, associate director of the FDA’s Drug Shortage Program, most are due to problems in manufacturing, ranging from contamination to late delivery of raw materials. Other problems include misprints on the labels and increased demand. (Health Day, Aug. 24)

The main mission of the FDA is to preserve the safety and efficacy of drugs sold in the U.S. by working with these companies when they do have problems to keep these low-cost but effective generic drugs on the market.

Jensen of the FDA; Dr. Otis Brawley, chief medical officer at the American Cancer Society; and The Economist in a Sept. 3 article all point to the low prices for these generic drugs as the real reason for the shortages. The handful of companies involved in producing the drugs are not making the exorbitant profits they want, so they restrict their production to cherry pick what they make the most on which is not necessarily what patients in the U.S. need.

This is just another example of how markets designed around profits fail to serve the needs of the people.