Pharmaceutical shortfalls trigger treatment dilemmas

Many drugs are in short supply, and the solutions to the complex problem are elusive.

By Susan J. Landers, AMNews staff. March 26, 2001.

Washington -- Last-minute medication changes, rescheduled surgeries and delayed booster shots are becoming more common across the nation as increased numbers of pharmaceuticals become scarce commodities.

First, reports regarding flu vaccine production delays and spot shortages made big news last fall. More recently, a shortfall in tetanus vaccine supplies made headlines. But it is becoming evident that these examples may not necessarily be exceptions in what is usually considered an efficient drug supply-demand pipeline.

Specifically, physicians have been grappling with serious shortages of numerous drugs for several months, and the situation seems to be growing worse.

"I've been in this game for 35 years, and I've never seen a shortage of critical drugs like this before," said Bruce Cullen, MD, chief of the Anesthesiology Dept. at Harborview Medical Center in Seattle.

The shortages cover a wide range of pharmaceuticals from anesthetics to vaccines to antibiotics. Some drugs are no longer being produced at all.

Drug shortages are becoming more common, acknowledged Mark Goldberger, MD, who is involved in managing the shortages at the Food and Drug Administration's Center for Drugs. Shortages affect the entire range of medical specialties. And there are several complex reasons behind their occurrence, Dr. Goldberger said. Among them:

• Consolidations in the pharmaceutical industry have resulted in only one or two firms producing a particular drug. Any production problems can rapidly lead to nationwide shortages.