The hospital shortage of needed medications is getting worse: blame the free market

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I’ve written before (here and here) about an alarming trend — shortages in hospitals of important, sometimes life-saving medications. The problem is most acute for drugs we inject into the body rather than pills. The Food and Drug Administration (FDA) keeps a list of drugs in short supply; it is long and getting longer. Things aren’t getting better; they’re getting worse. The items on the list now number in the hundreds. The list changes so frequently from day to day that hospitals scramble with a real-time way of keeping track.

Just yesterday I learned that chloral hydrate, an old, old medicine, will not be made anymore. The one company making it has decided to stop. Although it’s an old drug, chloral hydrate still has an important place in the toolkit of doctors like me who sedate infants and small children for procedures. Now we won’t have it anymore. Why do we have these shortages? What’s going on?

The problem is that the drugs in short supply are virtually all generic, off patent. They are cheap. So the profit margins for the manufacturer is slim. A drug company can make much, much more money by looking for yet another “me too” drug we don’t need. The old standby drugs, the injectable ones we need everyday, are cast aside. A related problem is that, for many of these drugs we still can get, only one factory makes them. So if there’s a problem at the factory, there is an instant nation-wide shortage.

What’s the solution? I see no other way than for some federal authority to subsidize the production of these medicines in a way that allows the companies making them to make a reasonable profit. The totally free market got us into this mess, and it won’t get us out. If anything, it will get worse.