SoylentNews

NotSanguine [soylentnews.org] writes:

From the no-shortages-for-the-mexican-cartels dept.

The New York Times is reporting [nytimes.com] on the impact of serious shortages in a wide variety of pharmaceuticals on the quality of health care in the United States.

In the article [nytimes.com][semi-paywalled], Sheri Fink elucidates some of the more alarming details:

In recent years, shortages of all sorts of drugs — anesthetics, painkillers, antibiotics, cancer treatments — have become the new normal in American medicine. The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products. But while such shortages have periodically drawn attention, the rationing that results from them has been largely hidden from patients and the public.

At medical institutions across the country, choices about who gets drugs have often been made in ad hoc ways that have resulted in contradictory conclusions, murky ethical reasoning and medically questionable practices, according to interviews with dozens of doctors, hospital officials and government regulators.

Some institutions have formal committees that include ethicists and patient representatives; in other places, individual physicians, pharmacists and even drug company executives decide which patients receive a needed drug — and which do not.

Fink goes on to discuss the impact of rationing regimes and the (sometimes) negative impacts they have:

Such decisions have real consequences. For some shortages, doctors can soon see the effects of rationing, such as increased pain or nausea when drugs typically used to control symptoms are withheld, or patients who have to undergo invasive surgery to control cancer when anti-tumor medications are delayed.

Studies have associated alternative treatments during drug shortages with higher rates of medication errors, side effects, disease progression and deaths. For example, children with Hodgkin’s lymphoma who received a substitute to the preferred drug had a higher rate of relapse, researchers found, and adults with a genetic disorder called Fabry disease had decreased kidney function when their medication was cut by two-thirds. One alternative guideline adopted during a shortage of intravenous nitroglycerin “was downright scary from a clinical perspective,” according to Dr. Nicole Lurie, a senior federal health official.

Physicians say that many of the changes they are compelled to make appear to do no harm. But, they acknowledge, typically no one is tracking outcomes in patients who get a drug and others who get a substitute or delayed treatment. [emphasis added]

Researchers at the Mayo Clinic published a paper last year [elsevier.com] [abstract only] discussing the impact of shortages on patient safety as related to anesthesia.

I guess that the question which first comes to my mind is, "In a place where we pay more for pharmaceuticals than any other country, and where healthcare costs are enormously higher (in terms of per capita outlays and as a percentage of GDP) than other places around the world, why are we facing such issues?" I imagine that the answer is multi-faceted and wouldn't reflect very well on the pharmaceutical, insurance and health care industries.

What say you, Soylentils?

Original Submission