As a pediatric hematologist-oncologist, Yoram Unguru, MD, has had his share of heart-wrenching conversations. “But one of the hardest is sitting down with a patient and family and telling them there’s a drug that’s part of the curative regimen, but it’s not available because there’s a shortage,” says Unguru, who works at the Herman and Walter Samuelson Children’s Hospital at Sinai in Baltimore, Maryland. “Patients and parents give you a look of complete incredulity. ‘What do you mean it’s not available?’ Even after I explain why these shortages exist, many patients and families still have a hard time believing that a life-saving medication isn’t available in the U.S.”
Dozens of medical associations have warned about the dire consequences drug shortages pose for this country. In 2017, 146 drugs ran short, according to the American Society of Health-System Pharmacists. Between January 2008 and March 2014, shortages for lifesaving therapies quadrupled and shortages of drugs for which there is no alternative more than doubled, according to an analysis published in Academic Emergency Medicine. In fact, the Food and Drug Administration (FDA) recently acknowledged that “many of these shortages have been for critical drug products and that they are having a tangible impact on patients.”
Yet shortages continue. Some occur when pharmaceutical companies halt production because of lapses in quality or concerns about meeting FDA standards. Others arise when the raw materials needed to make medications or medical supplies run low. And natural disasters can cause shortages. The hurricane that ravaged Puerto Rico in 2017 knocked out several major pharmaceutical and medical supply makers, leading to shortages of medications and IV saline bags.
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