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Drug Shortages Hit Calif.

Shortage [Daily Press, Victorville, Calif.]

From Daily Press (Victorville, CA) (April 27, 2011)

April 27--Like losing that first tooth or learning to ride a bike, chickenpox is a right of passage for many children.

But when those dreaded red bumps surface and mom makes a beeline for the pharmacy, prescription in hand, the last thing she wants to hear is that the remedy for soothing her itchy kid isn't available.

For nearly two weeks, A Family Pharmacy in Hesperia has been trying to get a supply of Acyclovir, an antiviral drug used to treat chickenpox, shingles, herpes and other conditions that can lead to blistered skin. All four of the pharmacy's vendors are out, according to pharmacist Bob Pavlan, with patients still waiting to start treatment.

The growing shortage of prescription drugs has alarmed experts in the medical world, with the American Society o f H e a l t h -- Sy s t e m Pharmacists hosting a Drug Shortage Summit in November to tackle the problem.

R e p o r t s o f n ew drug shortages nearly tripled from 2005 to 2010, according to a recent study from the University of Utah's Drug Information Service. And most of the shortages haven't been in treatments for some rare disease, but in medicines for regrettably common conditions such as cancer or attention-deficit hyperactivity disorder.

"Last year we had a real problem. There were fairly common medicines routinely used -- probably 20 to 25 -- that were unavailable or hard to get," said Curt Emick, pharmacist at the SuperTarget on Highway 18 in Apple Valley. "Every once in a while the shortage is so low that we can't get something for a while, maybe even a month or so."

There's been a significant deficiency of the low blood pressure medicine Levophed, for example, according to Victor Valley Community Hospital spokeswoman Lovella Sullivan.

"When there's been a shortage, we've either found another source to provide them or found another substitute drug that was approved by the physician," Sullivan said, with vendors such as Cardinal Health hired to track down replacements.

T h e t r i c k t h e n becomes ensuring that patients receive the right doses. Dr. Michael Cohen, president of The Institute for Safe Medication Practices, told WebMD Health News that two patients recently died after hospitals ran out of morphine and incorrectly administered another pain reliever.

Then there's the issue of cost.

"There are substitutes," Pavlan said, "but insurance doesn't pay for them."

If the company producing a generic medicine goes offline, consumers are forced to fork over the difference for a brand-name drug -- or patients put off treatment altogether.

Even the price of generics has been steadily rising, according to Pavlan. Almost overnight, he said the cost of Glyburide, used to treat diabetes, skyrocketed from roughly $35 for a bottle of 1,000 tablets to $192.

"We think that it was only available by one manufacturer," Pavlan said, with that company then free to set its own price.

What's more frightening, Pavlan said, is what happens when that one manufacturer goes offline.

"What many people don't know is that very few of our drugs are actually produced in the United States," Pavlan said, with a March study from Prime Healthcare Alliance stating foreign markets such as China or Croatia supply as much as 80 percent of the raw materials required to make pharmaceuticals. "When a plant in India closes down -- is shut down by the FDA -- we're not able to get that drug."

Even if there are two or three companies making a product, Emick said if one goes down, the other companies often can't keep up with the rise in orders. Roughly half of the 60 or so "medically necessary" drugs on the Food and Drug Administration's shortage list are there due to increased demand.

Scarcity of a particular active ingredient or a recall by the FDA can also trigger shortages.

"It's a good thing in a way," Emick said, indicating the federal government has gotten better at monitoring drugs and pulling products that may not be safe.

While Pavlan has seen the shortage worsen over the last six months or so, local hospitals are reporting the drug supply seems to be improving, with no critical shortages at any of the three Victor Valley facilities.

"We're really pleased that things seemed to have stabilized in 2011," Jana Bullock, spokeswoman for Desert Valley Hospital, said. "In 2010 there seemed to be some shortage of prescription drugs, but the local health care community really partnered together."

Local hospitals have a strong network in place, according to St. Mary Medical Center spokesman Randy Bevilacqua, so that if one facility is running short on a medication another will step up and share.

Many experts fear that generosity may start to dry up, however, if the shortage continues to escalate the way it has over the last five years.

In February, Sen. Amy Klobuchar, D-Minn., and Sen. Bob Casey, D-Pa, introduced the Preserving Access to Life-Saving Medications Act, which would require prescription drug manufacturers to give early notification to the FDA of any incident that would likely result in a drug shortage and to maintain an online list of drugs that are running low.

"Physicians, pharmacists and patients are currently among the last to know when an essential drug will no longer be available -- that's not right," Klobuchar said in a statement. "This common-sense solution will help set up an early warning system so pharmacists and physicians can prepare in advance and ensure that patients continue to receive the best care possible."

The bill could face an uphill battle as it moves to committee, with pharmaceutical companies among the most powerful lobbyists in the country.

Brooke Edwards may be reached

at (760) 955-5358 or at bedwards@VVDailyPress.com.

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Copyright (c) 2011, Daily Press, Victorville, Calif.

Distributed by McClatchy-Tribune Information Services.

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Posted: April 2011


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