A friend of mine has leiomyosarcoma, a muscle tumor that is fatal in more than 60% of patients at five years. He is one of the lucky ones: he has battled this disease to a standstill over the past four years with the help of Johnson & Johnson's landmark Doxil (doxorubicin). But a big nationwide shortage means that my friend has been struggling to get his lifesaving doses.
And it's not just Doxil. According to the Premier Health Alliance, 180 drugs in the US this year are scarce, triple the number from five years ago. Over 80% of hospitals report that these shortages delay patient care. IHS Global Insight says this has led to a grey market with prices soaring more than 650%.
What's causing the shortages? First, 80% of raw materials for these drugs come from overseas, often causing delays. Second, many of these drugs are generic or about to turn generic, so there is a narrower profit margin and less financial incentive to make them. Third, the production process, especially for intravenous and injectable medications, requires an expensive and laborious sterilization process. Fourth, many of these drugs are prioritized for shipment to the war theatre in Afghanistan and Iraq, where they are stockpiled.
What is the solution? For one thing, we need incentives for raw material and supply production in the US. And the FDA needs to play a more effective role in identifying shortages. Thirdly, the government can, and should, stockpile emergency supplies of raw materials and lifesaving drugs that are running short, not just for the war, but also for use in US hospitals.
Marc Siegel MD is medical director of Doctor Radio at NYU Langone Medical Center. He is author of The Inner Pulse; Unlocking the Secret Code of Sickness and Health