Why we are having drug shortages...

This was found in an article written from a Doctor and Pharmacist in Southern Wisconsin.

The reason for our drug shortage includes:
http://gazettextra.com/news/2011/nov/20/national-drug-shortage-affects-southern-wisconsin-/

Manufacturing problems: Raw material shortages can make it difficult for manufacturers to bring drugs to market, said Don Janczak, director of pharmacy at Mercy Hospital and Trauma Center.
Business decisions: Two companies might merge and discontinue a drug both were producing, or manufacturers might make a business decision to discontinue a product. This is happening with many generic drugs that have been on the market for years because it might not be profitable to continue making the generic drug, Janczak said.
Regulatory standards: U.S. Food and Drug Administration inspections might force manufacturers to temporarily shut down production, and other companies can’t keep up.
President Barack Obama stepped in Oct. 31, ordering the FDA to help prevent and reduce drug shortages, protect consumers and prevent price gouging.
Pending legislation would require manufacturers to notify health care providers and wholesalers of impending shortages so people can prepare, said Jeff Elser, pharmacist at Dean Clinic.
A “gray market” for prescription drugs also has developed. Area pharmacists say they don’t buy from such suppliers, who price gouge, because they don’t know where the drugs are from.

I came across an interesting opinion article written in the Wall Street Journal by a physician who consults and invests with drug marketers. One of the causes of the shortage is that there is little incentive for companies to produce old generic drugs (specifically IV drugs) because there is a narrow profit for the manufactures. He points blame at the price caps that Medicare will pay for these drugs, so the companies cannot markup their price. While I do understand this argument, I am not sure that it is in the best interests of patients to open up the price market completely for these drugs. This could lead to a slippery slope of the costs of drugs continuing to rise and patients having no other choice, but to buy at that price. I do agree that there needs to be an incentive for companies to produce the less profitable drugs, but I fear that generic drugs could reach price ranges that defeat the purpose of their existence. Unfortunately the production of drugs is a business and very much run that way; even if it is at the cost of patient's lives.

Drug Shortage Affecting us as Nurses...

I wanted to find out how the drug shortage will be affecting us as nurses...
First of all it is obviously affecting our patients, "Papa reported that emergency nurses have seen patients suffer needlessly and experience adverse events when substitute medications were not as effective or because, in some cases, no substitutes exist." http://www.nursezone.com/Nursing-News-Events/more-features/Drug-Shortages-Affecting-Nurses-and-Patients_38484.aspx
This is what we need to be aware of, pain and altered discomfort is one of our major nursing priorities and we need to know our other options so we can make sure our patient 's pain is adequately managed.
This article reports that the drug shortage actually sets the nurse up for medication errors...when you do not have the right dose or you are giving a patient something they are not use to having can cause several problems.

Drug Shortages: How it Occurs and the Effects it Has

Monitoring and preventing drug shortages a job that is overseen by the FDA. The FDA has no authority to require companies to make drugs. Instead it works with industry, healthcare professionals and patients to prevent and lessen the severity of drug shortages. The FDA works with companies who manufacture drugs that are in shortage to communicate and work to make the drug more available. Manufactures are not required to report expected shortages, or how long the shortages are expected to last. This reporting is done on just a voluntary basis, though the FDA strongly encourages the drug manufactures to make this information known.

Drug shortages are an increasing problem in the United States. Many of the drugs that do become scarce are older generic drugs that are less profitable. In other cases, something goes wrong during the manufacturing of the medication, and the process has to be stopped. When just one or two companies are manufacturing a drug, and they have to stop making it, there is a deficit and the supply dips below the demand, resulting in a shortage. The FDA works with other manufactures that make the same drug to increase the production so they can help to compensate for this loss. It works to prevent shortage and to reduce the impact of a shortage. However, this is not always enough to compensate for this loss.

U.S. Drug Shortages From 2001 To 2010

(http://www.npr.org/blogs/health/2011/10/04/140958404/shortages-lead-doctors-to-ration-critical-drugs)

The effects of a drug shortage can be devastating. Drug shortages are causing doctors and drug manufactures to ration medications. Some of the medications that have been in shortage include: chemotherapy agents, anesthetics, antibiotics, electrolytes needed for nutrient solutions, blood pressure medication and much more. It can lead to death in some cases. Some patients have to go without the medication as doctors reserve to use it for the most critical patients. This can lead to doctors using different drugs, or combining other drugs, but this can lead to errors and a change in the therapeutic effect of the drug when alternative medications are used. There is no perfect alternative to the prescribed drug.

There are a couple steps that can happen right off the bat to combat and lessen this emerging crisis. First, the FDA can have a tighter regulation on the reporting by manufactures of drug shortages and the extent of predicted deficits. Also, if multiple companies were to make the same drug, if something happened during the manufacturing process of one drug, the other companies would be able to pick up the slack and lessen the effect of the shortage on the market.

http://www.fda.gov/Drugs/DrugSafety/DrugShortages/default.htm

http://www.npr.org/blogs/health/2011/10/04/140958404/shortages-lead-doctors-to-ration-critical-drugs