A couple weeks ago, DKoser KS LaVida wrote an excellent diary on why The looming antibiotic crisis can't be solved by the free market. While the focus in that piece was on the unwillingness of Big Pharma to create new antibiotics needed to prevent epidemics -- mainly because they are not profitable enough -- this problem is even wider. In recent years there have been hundreds of shortages of critical pharmaceuticals. The FDA maintains a long list of drugs currently in shortage -- shortages that in many cases are not resolving -- and shortages are coming to be regarded as a permanent new state in US health care.
Drugs in shortage include medical staples such as injectible antibiotics, and emergency room, EMT, and operating theater drugs. Most of the shortages result from manufacturing capacity that hasn't keep up with increasing demand, though some result from quality control problems or shortages in key ingredients. However, manufacturing capacity has fallen for many of these drugs because manufacturers have discontinued making them to pursue more profitable drugs.
In 2011, President Obama issued executive order 13588 - Reducing prescription drug shortages which ordered the FDA to spruce up its system for reporting and tracking shortages, and to identify manufacturers who are gaming the system by stockpiling drugs and creating shortages in order to jack up prices. But what the improved FDA tracking has demonstrated is that most shortages are simply caused by the fact that the market does not want to grow manufacturing capacity to meet demand -- in fact it wants to shift existing capacity to more profitable products.
In other words, we have a complete market dysfunction in the pharmaceutical industry.
This is a managed market, and unless we agree to large price rises in drugs, or large public outlays to private industry to create national strategic reserves, private sector manufacturing capacity is simply not going to produce enough of the things we need.
So I believe it is time to develop a public sector, non-profit manufacturing system for pharmaceuticals in shortage, and to develop new critical pharmaceuticals that the industry is not interested in developing.
Such a public manufacturing capacity would most naturally fit under the NIH, which has already become the main clearinghouse for all biomedical information and research though NCBI and PubMed.
Current Drug Shortages Index (Source: http://www.fda.gov/...
The majority of information in this section is provided to FDA by manufacturers. Communication between FDA and the public is an essential component of preventing and mitigating drug shortages. To ensure that the information in this section is current, FDA appreciates all information and updates about shortages provided by manufacturers. We post information about shortages as soon as we receive it from the manufacturers. To report information about shortages or supply issues, manufacturers can send updates to drugshortages@fda.hhs.gov. Healthcare professionals and patients are also encouraged to notify us of shortages at drugshortages@fda.hhs.gov.
*Listed by Generic name or Active Ingredient*
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
A
Acetylcysteine Inhalation Solution
Acyclovir Sodium Injection (initial posting 11/13/2012)
Alfentanil (Alfenta) Injection (initial posting 1/23/2012)
Alteplase (Cathflo Activase) (initial posting 1/27/2012) Updated 3/25/2013
Amikacin Injection
Amino Acid Products (initial posting 2/14/2012) Updated 3/26/2013
Aminocaproic Acid Injection (initial posting 3/8/2013) Updated 3/26/2013
Aminophylline (initial posting 12/10/2012) Updated 3/26/2013
Ammonium Chloride Injection (initial posting 3/8/2013)
Amytal Sodium Injection (initial posting date 1/31/2013)
Argatroban Injection (initial posting date 2/11/2013)
Atracurium besylate (initial posting 2/27/2012)
Atropine Sulfate Injection Updated 3/26/2013
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B
Bacteriostatic 0.9% Sodium Chloride (initial posting 9/10/2012)
Barium Sulfate for Suspension (initial posting 10/12/2012)
Bismuth subsalicylate/tetracycline hydrochloride/metronidazole (Helidac) Therapy (initial posting 3/8/2012)
Bumetanide Injection (initial posting 6/21/2012) Updated 3/26/2013
Bupivacaine Hydrochloride (Marcaine, Sensorcaine) Injection Updated3/26/2013
Buprenorphine hydrochloride (Buprenex) Injection
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C
Caffeine, anhydrous (125 mg/mL) and Sodium benzoate (125 mg/mL) Updated 3/26/2013
Caffeine and Ergotamine Tartrate Tablet (initial posting 3/8/2012)
Calcium Chloride Injection (initial posting 12/11/2012) Updated 3/26/2013
Calcium Gluconate Injection (initial posting 1/10/2013) Updated 3/26/2013
Cetrorelix Acetate for Injection (Cetrotide) (initial posting 9/20/2012)
Chromic Chloride Injection
Cidofovir Injection (initial posting 2/15/2013)
Citric Acid; Gluconolactone; Magnesium Carbonate Solution (Renacidin); Irrigation (initial posting 6/30/2012)
Cyanocobalamin Injection Updated 3/26/2013
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D
Daunorubicin Hydrochloride Solution for Injection
Denileukin diftitox (Ontak) injection (initial posting 9/22/2012)
Desmopressin Injection (DDAVP)
Dexamethasone Sodium Phosphate Injection (initial posting 1/15/2013)
Dexrazoxane (Zinecard) Injection
Dextrose Injection (initial posting 5/23/2012) Updated 3/26/2013
Diazepam Injection Updated 3/19/2013
Dipyridamole Injection (initial posting 7/24/2012)
Doxorubicin (adriamycin) lyophilized powder (initial posting 12/2/2011)
Doxorubicin Liposomal Injection Updated 3/19/2013
Doxycycline Hyclate (initial posting 1/18/2013) Updated 3/22/2013
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E
Edetate Calcium Disodium (Calcium Disodium Versenate) Injection (initial posting 10/12/2012)
Epinephrine Injection (initial posting 4/27/2012)
Epinephrine 1mg/mL (Preservative Free) (initial posting 6/21/2012) Updated 3/26/2013
Ethiodol (ETHIODIZED OIL) ampules
Etomidate (Amidate) Injection (initial posting 2/9/2012) Updated 3/26/2013
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F
Fentanyl Citrate (Sublimaze) Injection Updated 3/26/2013
Fluticasone Propionate and Salmeterol (Advair HFA) Inhalation Powder (initial posting date) - 10/17/2012)
Fosphenytoin Sodium (Cerebyx) Injection (initial posting 3/30/2012)
Fospropofol disodium (Lusedra) Injection (initial posting 6/18/2012)
Furosemide Injection (initial posting 6/20/2012) Updated 3/26/2013
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G
Gallium Nitrate Injection (Ganite) (initial posting 4/4/2012)
H
Heparin Sodium Premixes (initial posting 7/5/2012)
Hydromorphone Hydrochloride (Dilaudid) Injection (initial posting 3/7/2012) Updated 3/26/2013
Hydromorphone Hydrochloride Tablets (initial posting 2/19/2013)
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I
Ibandronate sodium (Boniva) injection (initial posting 6/6/2012) Updated 3/19/2013
Intravenous Fat Emulsion
Isoniazid Tablets
Isoniazid; Rifampin (Rifamate) Capsules 3/15/2013 New!
K
Ketorolac Tromethamine Injection Updated 3/26/2013
L
Leucovorin Calcium Lyophilized Powder for Injection Updated 3/26/2013
Leuprolide Acetate Injection
Levothyroxine sodium (Levoxyl) Tablets (initial posting date - 3/15/2013) New!
Lidocaine HCl, 4% Topical Solution (initial posting date - 2/12/2013)
Lidocaine (Xylocaine) Hydrochloride Injection (initial posting date - 2/22/2012) Updated 3/26/2013
Liotrix (Thyrolar) Tablets
Lorazepam (Ativan) Injection Updated 3/26/2013
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M
Magnesium Sulfate Injection Updated 3/26/2013
Mannitol Injection (Osmitrol, Resectisol) Injection (initial posting date - 12/21/2011)
Methazolamide (Glauctabs, Neptazane) Tablets
Methoxsalen (Oxsoralen) 1% topical lotion
Methyldopate HCL Injection
Methylphenidate Hydrochloride Tablets (initial posting date - 2/19/2013)
Methylphenidate Hydrochloride ER Tablets (initial posting date - 2/19/2013)
Methylin Chewable Tablets (initial posting date - 2 /19/2013)
Metoclopramide (Reglan) Injection
Midazolam HCL (Versed) Injection Updated 3/26/2013
Morphine Sulfate Injection Updated 3/26/2013
Morphine Sulfate (Astramorph PF, Duramorph, Infumorph) Injection (Preservative Free) Updated 3/26/2013
Multi-Vitamin Infusion (Adult and pediatric)
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N
Nalbuphine HCl (Nubain) Injection (initial posting 5/15/2012) Updated 3/26/2013
Naloxone (Narcan) Injection (initial posting 2/22/2012) Updated 3/26/2013
Neostigmine Methylsulfate Injection (initial posting 1/14/2013)
Nitroglycerin Ointment USP, 2% (Nitro-Bid) (Initial posting 10/23/2012)
Norethindrone and Ethinyl Estradiol Tablets, USP (Ovcon 50 Tablets) (initial posting 4/16/2012)
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O
Ondansetron (Zofran) Injection 2 mg/mL Updated 3/26/2013
Ondansetron Injection 32 mg/50 mL premixed bags
Oseltamivir Phosphate (Tamiflu) for Oral Suspension (6mg/mL 60 mL) (Initial posting 1/10/2013)
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P
Pancuronium Bromide Injection Updated 3/26/2013
Papaverine Hydrochloride Injection (initial posting 12/17/2012)
Peginterferon Alfa-2a (Pegasys) Injection-Prefilled Syringes (initial posting 3/26/2012)
Pentamidine isethionate inhalant (NebuPent) (initial posting 8/27/2012)
Pentamidine isethionate for injection (Pentam 300) (initial posting 8/27/2012)
Pilocarpine HCL Opthalmic Gel 4% (Pilopine HS) (initial posting 6/1/2012)
Potassium Acetate Injection, USP 2 mEq/mL
Potassium Chloride Injection 2 mEq/mL (initial posting 5/15/2012) Updated 3/26/2013
Potassium Phosphate Injection Updated 3/26/2013
Procainamide HCL Injection Updated 3/26/2013
Prochlorperazine Injection (initial posting 1/30/2012)
Promethazine Injection (initial posting 2/10/2012)
Propofol (Diprivan) Injection (initial posting 4/5/2012) Updated 3/26/2013
Pyridostigmine Bromide (Regnol) Injection
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R
Rifampin for Injection (initial posting 3/22/2013) New!
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S
Secretin Synthetic Human (ChiRhoStim) Injection (ChiRhoStim) (initial posting 6/15/2012)
Selenium Injection Updated 3/26/2013
Sodium Acetate Injection (initial posting 3/20/2012) Updated 3/26/2013
Sodium benzoate and Sodium phenylacetate (Ammonul) Injection
Sodium Bicarbonate Injection (initial posting 4/4/2012)
Sodium Chloride 0.9% (5.8mL and 20mL) (initial posting 5/4/2012)
Sodium Chloride 23.4% Updated
Sodium Phosphate Injection Updated 3/26/2013
Succinylcholine (Anectine, Quelicin) Injection (initial posting 8/17/2012)
Sufentanil Citrate (Sufenta) Injection
Sulfamethoxazole 80mg/trimethoprim 160mg/ml injection (SMX/TMP) Bactrim)
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T
Technetium Tc99m Bicisate for Injection (Neurolite) (initial posting 5/4/2012)
Technetium Tc99m Sestamibi Kit for Injection (initial posting 2/14/2012)
Telavancin (Vibativ) Injection
Tetracycline Capsules
Thiotepa (Thioplex) for Injection
Ticarcillin disodium/Clavulanic Potassium Injection (Timentin) (initial posting 8/16/12)
Ticlopidine (Ticlid) Tablets
Tobramycin Solution for Injection
Trace Elements (initial posting 1/24/2013)
Tromethamine (Tham) Injection (initial posting 5/2/2012)
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V
Vinblastine Sulfate Injection (initial posting 1/31/2012)
Vitamin A Palmitate (Aquasol A) Injection
Vitamin K Injection(initial posting 2/12/2013)
Z
Zinc Injection (initial posting 2/15/2012) Updated 3/26/2013