Drug shortages can kill children
Shortages of a long list of medications have been a problem for some time now. Many, many important drugs are in short supply. The FDA even keeps a list of them. The reasons for this are fairly well known. All of the drugs in short supply are generics, meaning they are off patent. This means the profit margins to be had for any company making them are very slim. The shortages mostly affect injectable drugs, not pills or tablets, because injectables are more expensive to manufacture. Often a particular generic injectable drug is made by only a few, or even a single, company. If there is a problem at the manufacturing plant, the supply can dry up quickly. The pharmaceutical industry does not really make drugs based upon what people need; they look at potential profits. So a drug for a rare condition does not have much chance.
One family of drugs long affected by shortages is that of injectable anti-cancer drugs. When that happens, cancer specialists sometimes can find other ways to treat the cancer. But often there is no equivalent medicine. A recent, disturbing article in the New England Journal of Medicine documents what can happen then. Faced with a shortage of a standard anti-cancer drug, called mechlorethamine, doctors had to devise an alternative treatment program for children with a cancer called Hodgkin’s lymphoma. As cancers go, this is a very curable one. Yet the children with the alternative program, without the mechlorethamine, did worse — much worse.
The authors’ conclusion is clearly correct:
Almost 80% of children and adolescents with cancer can be cured with current therapy. Most of the curative treatment regimens are based on chemotherapeutic agents that have been available for decades, but some of these have recently been in short supply. These shortages are likely to have devastating effects on patients with cancer and must be prevented.
We simply must find another way of ending these chronic generic drug shortages. This is not a problem a market-based, profit-driven pharmaceutical industry will fix on its own. They must be given some incentive, some reason to make these drugs. We are talking life and death here. The authors of the article rightly call this . . .
“an intolerable situation for young people with curable diseases.”