Dr. Mitch can only provide general medical insights. He cannot counsel you on your own particular case. Information about a specific individual's medical condition can only properly be managed by a health care professional who has examined that person and done a proper evaluation. Furthermore, Dr. Mitch will not be able to respond to individual requests for referral or diagnosis or management or to provide a second opinion. His intent is to help people know more about medicine and science so that they can ask their health care professional the right questions and make more informed decisions with respect to their health. You should consult with your health care professional before following any of Dr. Mitch's advice to confirm that it is appropriate for you.

 

Why Can`t We Get The Drugs We Need When We Need Them?

Drug shortages are in the news again. This is not a new problem and it`s not going to be resolved any time soon. It`s not an issue limited to Canada and it`s not specific just to people, as veterinarians are affected also. And it`s not an issue of generic vs branded drugs.  A number of factors have created this recurring ``perfect storm``. 

To save on cost, all pharmaceutical companies (generic and branded) have concentrated their manufacturing. A single site now makes the world-wide supply of a number of different products. Thus a problem at one plant can shut out many different products for the entire world. Not only must the issue be resolved but the plant must then be certified by the appropriate regulatory agency, a process that can take months.

Next, raw materials for almost all of our drugs come from a few places. India and China play pre-eminent roles. Recently the head of the American FDA travelled to India to deal with quality control issues there. There has been pushback because of the increased cost this will entail. China has been very resistant to outside intervention.

To add to the problem, large amounts of drugs aren`t stockpiled to save on inventory costs. If there`s a hiccup anywhere in the supply chain, there may not be reserves available.

What can you do about this?

Often we have safe substitutes. It`s not optimal to change from a drug your body has gotten used to but it can be done safely. Pharmacists have been doing an incredible job staying on top of this. Unfortunately however in some cases (cancer and some heart rhythm drugs are the examples that spring to mind), we do not have the luxury of equivalent alternatives. That`s a real concern. What you can do is make certain that once you`ve been stabilized on a specific drug you get as much as your drug plan will allow and store it properly.

The Bigger Solution

 This is definitely a situation that demands a coordinated effort across borders (perhaps under the auspices of the World Health Organization). The suppliers of raw material need to be inspected regularly and forced to conform to standards of purity that are universal. Pharmaceutical companies are already working together with wholesalers and within their own organizations to deal with supply chain and stockpiling issues and drugs could be moved from one country to another if supplies are available. Here`s where the Federal government needs to play a role as they regulate importation. Essential medications which do not have alternatives should be stockpiled to meet reasonable emergency needs.

Perhaps now you can see why this is not a simple issue and unfortunately, why it`s not likely to be resolved any time soon!

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