Prescription drug shortages have become an increasing problem over the past two years, according to a Globe and Mail report. While drug shortages affect people of all ages, seniors are particularly vulnerable when life-sustaining medications are suddenly no longer available. Seniors are more likely to skip doses rather than seek the help of a physician to obtain an alternative, and many don't know what steps to take if they can't obtain a needed medication.
Multiple reasons for shortages
Interestingly, manufacturers aren't required by law to report drug shortages, so consumers usually only find out when they attempt to have a prescription filled. There are a number of factors that can contribute to sudden shortages:
- Increase in demand
- Discontinued medications being phased out by newer, brand-name pharmaceuticals
- Manufacturing/quality control issues and recalls
Big-name pharmaceutical companies make their money from brand-name medications for which no generic alternative is available. Companies typically obtain a patent on the specific molecular structure of a medication, which restricts generic drug-makers from replicating the formula. When the patent runs out, generics take over in terms of market share due to affordability, and the brand-name product ceases to be a money-maker for pharmaceutical giants.
If a shortage of a generic prescription medication means the only alternative is the drug's brand-name counterpart, pharmaceutical companies could have financial incentive for creating faux shortages by decreasing production. Pharmaceutical companies, of course, deny these allegations, but the truth is anyone's guess.
Chemotherapy drugs in crisis
One major concern is a shortage of chemotherapy drugs, according to Clinical Oncology News. In September, 23 generic and brand-name chemotherapy drugs had reported shortages, often resulting in patients skipping one or more treatments. There's now a waiting list, and practitioners have been faced with making difficult rationing decisions, such as moving patients with curable disease to the top of the waiting list.
Substitutions are more difficult when it comes to chemotherapy. Some of the medications in shortage are those used when all other regimens have failed, meaning no adequate substitution is available. In other cases, substitutions increase the likelihood of medical error, because it can be difficult to convert to the proper dosage of a new treatment.
It's particularly difficult when a patient has been responding well to a treatment that suddenly becomes available. In many cases, the substitution has a much lower cure rate, literally putting patients' lives at risk.
The White House responds
President Obama, in response to the increasing drug shortage crisis, is recommending new legislation which would require manufacturers to report shortages to the FDA, giving suppliers more time to find viable alternatives. The Denver Post says the bill wouldn't force manufacturers to increase production, but would provide more time for providers and patients to prepare for upcoming shortages.
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