Drug shortages article and price gouging
-----------------------------
Critical lack of drugs called 'pressing public health issue'
Below:
WASHINGTON — Federal officials and lawmakers, along with the drug industry and doctors' groups, are rushing to find remedies for critical shortages of drugs to treat a number of life-threatening illnesses, including bacterial infection and several forms of cancer.
The proposed solutions, which include a national stockpile of cancer medicines and a nonprofit company that will import drugs and eventually make them, are still in the early or planning stages. But the sense of alarm is widespread.
'Shortages are just killing us'
"These shortages are just killing us," said Dr. Michael Link, president of the American Society of Clinical Oncology, the nation's largest alliance of cancer doctors. "These drugs save lives, and it's unconscionable that medicines that cost a couple of bucks a vial are unavailable."
Story: Price-gougers hike costs of vital drugs during shortage
Don't miss these Health stories FeaturePics stock Add cinnamon to bounce back from a binge
If you overdid it at dinner, reach for cinnamon to ease indigestion. Click for more of TODAY’s do-it-yourself “Detox your life” tips.
.Tainted wipe maker sues vendor who won't pay
'Allo, guvnah! Mimicking accents may be innate talent
Single people may die younger, new study finds
Hospitals take 'hard stop' on early elective C-sections
..So far this year, at least 180 drugs that are crucial for treating childhood leukemia, breast and colon cancer, infections and other diseases have been declared in short supply — a record number.
Prices for some have risen as much as twentyfold, and clinical trials for some experimental cures have been delayed because the studies must also offer older medicines that cannot be reliably provided.
On Wednesday, Dianne Nomikos, 65, went to M. D. Anderson Cancer Center in Houston for a 9 a.m. appointment to receive Doxil, a vital medicine for her ovarian cancer. She was told to go home and wait until new supplies arrived.
"My life is in jeopardy," she said through tears in a telephone interview. "Without the drug, who knows what's going to happen to me?"
Advertise | AdChoicesAdvertise | AdChoices
Advertise | AdChoices
.The Obama administration is considering creating a government stockpile of crucial cancer medicines. The Centers for Disease Control and Prevention already stockpile antibiotics, antidotes and other drugs needed in the event of a terrorist attack or earthquake.
Under one plan, the government would store the dry ingredients for cancer drugs and, in the face of a shortage, distribute them to hospitals, where pharmacists could mix them into injectable compounds.
Dr. Richard Schilsky, a professor of medicine at the University of Chicago, said the number of cancers diagnosed in a year was easy to predict. "So we ought to be able to make a pretty good estimate of the grams required to treat every patient in the country in any given year," he said.
Legislation proposed
Legislation proposed in both the House and the Senate would give the Food and Drug Administration the power to demand that drug makers give early warnings of possible supply disruptions. Senator Amy Klobuchar, Democrat of Minnesota, said the idea behind the bipartisan bill came after she found that the agency had prevented 38 shortages last year after getting early alerts of problems at drug makers.
"I can't say the drug companies are excited" about the proposed legislation, she said in an interview. "But we need to give the F.D.A. more time."
A group of leading oncologists has started a not-for-profit drug company that it hopes will soon be able to import supplies of some of the missing medicines. The company will eventually manufacture the drugs itself, according to Dr. George Tidmarsh, a pediatric oncologist and biotechnology entrepreneur who will lead it.
"We have a meeting with the F.D.A. next week," Dr. Tidmarsh said. "This unfolding tragedy must stop, and right now."
More than half the recent shortages have resulted because government or company inspectors found problems like microbial contamination that can be lethal on injection. Others have occurred because of capacity problems at drug plants or lack of interest because of low profits, according to the F.D.A.
Doxil, the cancer drug Ms. Nomikos needs, is made by Johnson & Johnson. Monica Neufang, a company spokeswoman, said, "Our third-party manufacturer has had some manufacturing issues related to capacity."
Heather Bresch, president of the generic drug giant Mylan, says the shortages grow out of a sweeping consolidation of the generic drug industry into a few behemoths that compete only on price and have foreign plants that are rarely inspected.
"The race to the bottom has led to an increase of products coming from plants in China and India that may have uncertain supply and may have never been inspected," Ms. Bresch said. "If the F.D.A. was required to inspect foreign drug plants at the same rate it does domestic ones, we might not have so many of these shortages."
Ms. Bresch has helped to broker an agreement that would require the industry to pay $299 million a year for increased inspections of foreign drug plants, a deal that must be approved by Congress and one she says will prevent some shortages.
Advertise | AdChoicesAdvertise | AdChoices
Advertise | AdChoices
.Top government officials have held a blizzard of meetings in recent weeks to tackle the shortage issue, and more are expected over the next month — including a public advisory meeting at the F.D.A. and hearings in Congress.
'Pressing public health issue'
"Drug shortages represent a pressing public health issue, and we are actively working to understand the causes, the full scope of the problem in the U.S. and internationally, and possible solutions," said Dr. Howard K. Koh, an assistant secretary for health.
A crucial problem is disconnection between the free market and required government regulation. Prices for many older medicines are low until the drugs are in short supply; then prices soar. But these higher prices do little to encourage more supply, because it can be difficult and expensive to overcome the technical and regulatory hurdles. And if supplies return to normal, prices plunge.
Executives at Premier, a hospital buying cooperative, said that in April and May its members received hundreds of offers from obscure drug wholesalers to sell drugs in short supply at vastly inflated prices. Of the 636 offers that included a price, 45 percent were at least 10 times the normal rate and 27 percent were at least 20 times normal.
Such sales offers are legal as long as suppliers prove that they bought the drugs appropriately. Some wholesalers buy certain drugs in large quantities because they are betting there will be a shortage. The excessive buying can help make their predictions come true. "We never like to see a situation where people can profit off of a national crisis and engage in price gouging," Mike Alkire, Premier's chief operating officer, said in an interview.
Joyce Burke, 47, of Mooresville, N.C., has breast cancer and is worried that she might not be able to get Taxol, which is in short supply. A drug that might have been substituted for Taxol has a side effect that leads some patients to lose their fingernails.
"I was not looking forward to losing my fingernails," she said.
On Thursday, she received her first dose of Taxol, and her doctor said he had secured enough of the drug to give her a second dose in a little more than a week. She will need four doses to complete the treatment.
"And I asked, ‘What happens if you can't find the rest?' " Ms. Burke said. "It's not nearly as effective if you switch drugs midway through."
This article, "U.S. Scrambling to Ease Shortage of Vital Medicine," first appeared in The New York Times.
Copyright © 2011 The New York Times
Comments
-
overcharged, willfully deprived and politically stampeded
I am going to focus on IV 5FU.
About a dozen years ago, the FDA surprisingly failed to approve oral UFT, then a soon-to-be inexpensive 5FU generic, in the US. The FDA failed to simply catch us up with the rest of the world.
Even the limited testing then showed UFT with comparable survival to IV 5FU with less toxicity, lower administration costs, and less inconvienence. My personal assessment is that optimally used, UFT is often *better* than standard IV 5FU backbones, or at least UFT has distinct advantages. Especially for many antiangiogeneic-antimetastatic situations in CRC, particularly when used t.i.d. with cimetidine, PSK and ascorbate+quinones.
Parenteral products like IV 5FU require more QA/QC under more scrupulous conditions of manufacture than similar oral drugs like UFT. If the FDA had properly approved UFT around 1999, Xeloda would have had effective price competition (figure -50% to -75% retail price), and basic backbone 5FU treatments might be roughly equivalent priced to generic fluoroquinilones, say from under $50, up to $100-200 a month, instead of $XXXX per month for IV 5FU or Xeloda. UFT manufacture for oral use can be available as low tech in many countries. But Roche (Xeloda), some infusion based practices, and opportunistic never-waste-a-good-crisis politicians or bureaucrats might hate it.0 -
Big Pharmatanstaafl said:overcharged, willfully deprived and politically stampeded
I am going to focus on IV 5FU.
About a dozen years ago, the FDA surprisingly failed to approve oral UFT, then a soon-to-be inexpensive 5FU generic, in the US. The FDA failed to simply catch us up with the rest of the world.
Even the limited testing then showed UFT with comparable survival to IV 5FU with less toxicity, lower administration costs, and less inconvienence. My personal assessment is that optimally used, UFT is often *better* than standard IV 5FU backbones, or at least UFT has distinct advantages. Especially for many antiangiogeneic-antimetastatic situations in CRC, particularly when used t.i.d. with cimetidine, PSK and ascorbate+quinones.
Parenteral products like IV 5FU require more QA/QC under more scrupulous conditions of manufacture than similar oral drugs like UFT. If the FDA had properly approved UFT around 1999, Xeloda would have had effective price competition (figure -50% to -75% retail price), and basic backbone 5FU treatments might be roughly equivalent priced to generic fluoroquinilones, say from under $50, up to $100-200 a month, instead of $XXXX per month for IV 5FU or Xeloda. UFT manufacture for oral use can be available as low tech in many countries. But Roche (Xeloda), some infusion based practices, and opportunistic never-waste-a-good-crisis politicians or bureaucrats might hate it.
This issue discussed is starting to give me some insight into what has been puzzling me for some time recently. I am a family physician and seeing the growing shortage of medications has puzzled me and I can't wrap my hand around it. Intuitively it is related to money. Now that I am on chemotherapy for stage IIIB Colon Cancer, I am starting to also get a little nervous. One of my bigger fears is that my care will be directed not by what is best for me, but rather by the insurance companies and pharmaceutical company manipulations. I know that tragically many people with cancer have had treatment jeopardized
It's hard for me to discuss this very long without becoming profane . I will respect the dignity of this site and avoid doing so.
Drug companies have been found to be paying generic manufacturers large sums of money to not produce a competitor. There are six pharmaceutical companies on the fortune 500, and they make more money than all of the other fortune 500 companies combined. Until the recent emergence of a generic for Imitrex for migraine headaches, there have been no generics available for any migraine treatments or steroid inhalers for asthma. Of course relevant also are the cancer drugs. People with headaches, asthma, and cancer aren't in a bargaining or shopping position for medication.
I will wrap it up, but first will add that the FDA is controlled by the drug companies. To me, this is similar to the drug cartels controlling the governments in South America. This is considered also on my website (http://www.normponders.com/id36.html)
I apologize if I offend anyone. I plead chemo brain from XELOX treatment. Actually I've had strong feelings about this issue for a long time.
Norm0 -
skipping FDA related shortagesKimo Sabe said:Big Pharma
This issue discussed is starting to give me some insight into what has been puzzling me for some time recently. I am a family physician and seeing the growing shortage of medications has puzzled me and I can't wrap my hand around it. Intuitively it is related to money. Now that I am on chemotherapy for stage IIIB Colon Cancer, I am starting to also get a little nervous. One of my bigger fears is that my care will be directed not by what is best for me, but rather by the insurance companies and pharmaceutical company manipulations. I know that tragically many people with cancer have had treatment jeopardized
It's hard for me to discuss this very long without becoming profane . I will respect the dignity of this site and avoid doing so.
Drug companies have been found to be paying generic manufacturers large sums of money to not produce a competitor. There are six pharmaceutical companies on the fortune 500, and they make more money than all of the other fortune 500 companies combined. Until the recent emergence of a generic for Imitrex for migraine headaches, there have been no generics available for any migraine treatments or steroid inhalers for asthma. Of course relevant also are the cancer drugs. People with headaches, asthma, and cancer aren't in a bargaining or shopping position for medication.
I will wrap it up, but first will add that the FDA is controlled by the drug companies. To me, this is similar to the drug cartels controlling the governments in South America. This is considered also on my website (http://www.normponders.com/id36.html)
I apologize if I offend anyone. I plead chemo brain from XELOX treatment. Actually I've had strong feelings about this issue for a long time.
Norm
Two years ago I (legally) imported a Canadian drug with minor paperwork, to replace the generic drug made artificially unavailable by the FDA in the US. However the treatment gap permanently damaged a relative's health. The drug's US price subsequently rose 20 fold over the previous generic price, after 2-3 US generic drug makers dropped out of the drug's supply....
My question is whether oral UFT and oral leucovorin (LV) are available in Mexico, Canada or other convenient travel spots, up to the 600 mg/day of tegafur maximum dosage.
UFT+LV legally prescribed then mailed and/or walked across in 90 day batches might be a patient boon in the typical 300-400 mg tegafur daily doses used with leucovorin tablets, cimetidine, PSK and ascorbate+quinones. We spend time overseas and use prescribed UFT+LV for under $200 per month total cost (no insurance involvement, IV 5FU or IV LV).
Based on the early literature, we believe long term, daily low dose UFT treatment cocktails to be superior in preventing microscopic spread, with aggressive surgery or abalation for anything macroscopic. No down days offline for chemo effects in the last year either.0 -
-
System is broken
The American medical model hasn't worked for a long time. Unfortunately, I don't think things are going to change any time soon.
I am lucky enough to have great insurance, but often feel guilty that the amounts spent on me could fund basic or preventive care for dozens and dozens of healthier people...0 -
I'd first heard of cancer drug shortages almost two years agodaBeachBum said:System is broken
The American medical model hasn't worked for a long time. Unfortunately, I don't think things are going to change any time soon.
I am lucky enough to have great insurance, but often feel guilty that the amounts spent on me could fund basic or preventive care for dozens and dozens of healthier people...
and amazingly, situation has gotten worse......http://consumer.healthday.com/
Article.asp?AID=656187
For a disturbing item on FDA (from a bodybuilding site,no less):
www.ironmagazine.com/blog/2011/major-drug-research-company-faked-thousands-of-documents-to-get-drugs-approved-fda-says-no-big-deal/
(title says it all!!)0 -
Not for Profit Cooperative Pharmacutical Companies
Please write Minnesota Sen Amy Klobuchar who took on AT&T and Verizon for taking over regional cell phone companies saying they would provide better service and instead we saw higher prices and Verizon charged MN National Guard Members Exhorbitant Prices to cancel their contracts when deployed to Iraq.
I think the time has come for a Not for Profit Company to provide those inexpensive cancer treatment drugs like 5Fu and Luecivorn the for profit Monopolistic Drug Companies do not make because of little profit. The Drug Companies are now price gouging and taking advantage of the shortage they created and threatening we cancer treatment patients. Please support those effort of the Onocologists who work hard to provide life saving treatments for their patients.
Please write Sen. Amy Klobuchar in support of a Non Profit Pharmacutical to make sure the drug companies no longer "rig" the market for extreme profits at patient expense and loss of lives.
NB0 -
A struggle I have alsodaBeachBum said:System is broken
The American medical model hasn't worked for a long time. Unfortunately, I don't think things are going to change any time soon.
I am lucky enough to have great insurance, but often feel guilty that the amounts spent on me could fund basic or preventive care for dozens and dozens of healthier people...
"I am lucky enough to have great insurance, but often feel guilty that the amounts spent on me could fund basic or preventive care for dozens and dozens of healthier people..."
daBeachBum, this is something I struggle with also. The cost for the first year of treatment for this cancer, with surgery, is probably going to be a few hundred thousand dollars--with absolutely no guarantee of lengthening one's life at all. As a matter of fact, if you read the "statistics", it might be as few as three or four months of increased life.
Something needs to be done to stop the pharmaceutical companies and the medical community from charging exorbitant prices because of our fears of dying. That is completely immoral and we should be up in arms about this as a country.
I just received the statement of payment from our insurance company for my colonoscopy. The doctor charged $1000 for the procedure but the insurance company received over $600 in discounts so they only paid $300 for the procedure. If that's all the doctor needed, why did he charge $1000? Made no sense to me at all.0 -
I would rather have open competition from new and overseas suppliers with a non-FDA vetting mechanism and strict legal liability on product quality. It is some of the FDA restrictions that create the shortages and prevent new players from entering.relaxoutdoors08 said:Not for Profit Cooperative Pharmacutical Companies
Please write Minnesota Sen Amy Klobuchar who took on AT&T and Verizon for taking over regional cell phone companies saying they would provide better service and instead we saw higher prices and Verizon charged MN National Guard Members Exhorbitant Prices to cancel their contracts when deployed to Iraq.
I think the time has come for a Not for Profit Company to provide those inexpensive cancer treatment drugs like 5Fu and Luecivorn the for profit Monopolistic Drug Companies do not make because of little profit. The Drug Companies are now price gouging and taking advantage of the shortage they created and threatening we cancer treatment patients. Please support those effort of the Onocologists who work hard to provide life saving treatments for their patients.
Please write Sen. Amy Klobuchar in support of a Non Profit Pharmacutical to make sure the drug companies no longer "rig" the market for extreme profits at patient expense and loss of lives.
NB0
Discussion Boards
- All Discussion Boards
- 6 CSN Information
- 6 Welcome to CSN
- 121.9K Cancer specific
- 2.8K Anal Cancer
- 446 Bladder Cancer
- 309 Bone Cancers
- 1.6K Brain Cancer
- 28.5K Breast Cancer
- 398 Childhood Cancers
- 27.9K Colorectal Cancer
- 4.6K Esophageal Cancer
- 1.2K Gynecological Cancers (other than ovarian and uterine)
- 13K Head and Neck Cancer
- 6.4K Kidney Cancer
- 671 Leukemia
- 793 Liver Cancer
- 4.1K Lung Cancer
- 5.1K Lymphoma (Hodgkin and Non-Hodgkin)
- 237 Multiple Myeloma
- 7.1K Ovarian Cancer
- 63 Pancreatic Cancer
- 487 Peritoneal Cancer
- 5.5K Prostate Cancer
- 1.2K Rare and Other Cancers
- 540 Sarcoma
- 732 Skin Cancer
- 653 Stomach Cancer
- 191 Testicular Cancer
- 1.5K Thyroid Cancer
- 5.8K Uterine/Endometrial Cancer
- 6.3K Lifestyle Discussion Boards