Critical Shortages Of Generic Drugs Are Hurting Our Patients

It is high time we take this problem into our own hands

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50 mg of IV diphenhyrdamine, please.”

Doctor, I’m sorry. You can’t order that.

Why not?

It’s on shortage. We don’t know when we will get more.

More and more frequently, this conversation is happening in hospitals across our country. It happens to me on almost a daily basis, and it is extremely frustrating.

According to the American Society of Health System Pharmacists (ASHP), there are currently 200 medications that are currently on shortage. These include critical drugs such as IV amiodarone (a heart rhythm drug), IV cefuroxime (an antibiotic), IV atropine (a life-saving heart medication), and even IV diphenhydramine, which is used for life-threatening allergic reactions. 200 medications!

And it is really making it difficult to take care of very sick patients in the hospital, especially in the ICU. Now, there may be oral versions, but many times, the patient is so sick that he or she can’t take the oral formulation. And so, I am stuck — unable to provide life-saving medications because it is on shortage.

For diphenhydramine, for example, the reasons listed on the website are as follows:

As for when more will become available, here it what it says:

So what do I do now, today, for my patient with a swollen airway that needs IV diphenhyrdamine? Many times, the pharmacists just shrug their shoulders.

Something has to be done, and a number of hospital systems have now taken matters into their own hands.

The initiative got very little attention. I have only seen press reports about it from last September, but the initiative was actually announced in January of this year:

The new company is called CivicaRx, and according to the website, they expect to begin placing its first products on the market in 2019. It is about time.

We will have to see what the for-profit pharmaceutical industry does in response. For my part, I have reached out to the company on behalf of my own hospital and am waiting for CivicaRx to get back to me.

The drug shortage is a national health crisis, and I have always joked that I should “start my own drug company.” Well, over 500 hospitals across the country beat me to it, and I am so very glad they did.

The opinions expressed in this post are my own and do not reflect those of my employer or the organizations with which I am affiliated.

Written by

NY Times featured Pulmonary and Critical Care Specialist | Physician Leader | Author and Blogger | His latest book is “Code Blue,” a medical thriller.

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