Site Content

Tuesday

Pharmaceutical Shortage

Running out of medications? No pharmaceutical tracking or early waring system in place?

How can we be running out of medication used to treat everyting from cancer to medical emergencies? After 9/11, Anthrax, SARS, and more recently, Swine Flu (H1N1)...how is this possible?
Even more perturbing is the revelation that no early warning system is in place to alert the medical community to an impending shortage?

After nearly ten-years of preparedness, billions trillions  a lot of money spent on biological preparedness under Homeland Security we have found (or just awoke to notice) a major hole in our defenses. I must admit that I believed (wrongly) that there was a system in place to detect shortages in raw materials or production. Then again, I must have been blind to it...I remember getting notices from our local EMS system informing us that shortages of epinephrine had occurred almost overnight. I never related the situation to the large picture of Homeland Security Domestic Preparedness. Then again, our obvious inability to ramp-up flu vaccine production should have been a warning, too.

Its one thing to run out of a medication (or any other resource)...its quite another issue to not see it coming. According to media reports, hospitals are postponing or cancelling surgery and delaying cancer treatments due to the lack of medications.

Pharmaceutical shortfalls have been looming for several years. There seems to be several theories as to why, but no firm explanations. With no definition of the problem or cause it seems unlikely that a solution will be found anytime soon. According to 13WHAM (Rochester, NY):
"U.S. Senator Chuck Schumer says the shortages are unacceptable. He is backing legislation that would direct the Food and Drug Administration to give hospitals and pharmacies early warning when there are shortages of certain drugs. He says that would give them more time to find alternative medications."
Legislation (FDA) will not fix this problem. After all the Bioterrorism security preparedness time and money, after all the NIMS training, and after we've been encouraged to "See Something? Say Something" or disrobed, prodded, and felt by the TSA, we have no ability to predict/preempt medication shortages...of medication the health care community uses every day. Imagine what life will be like when some disease gets out of control...naturally or intentionally.

Inhalation Anthrax, for example; can be treated with common antibiotics...if you can get them...but what if antibiotics were in short supply? We've already seen how the media, and by result, the public, response to shortages of medications...real or imagined. For a good reminder about how the public reacts when expectations are not met, review this post from May, 2009. The good news is inhalational Anthrax is not transmitted person-to-person. What if another biological agent (naturally occurring or intentional) like Smallpox? Perhaps a novel Type A Influenza and no vaccine production ability would be another good example.

Would we be able to rely on non-pharmaceutical interventions to prevent the spread of disease? How long would it take to recognize a biological event was unfolding?


We've learned nothing from our experiences with SARS and flu. What will we learn from this little bit of awakening? Will we take some action to prepare ourselves despite the pharm/government failures or hit the snooze alarm...I'll bet most people will remain blind to the fact that  pharmaceutical shortages and lack of an early warning system has a major impact on Domestic Preparedness.