What would you do if your medicine were unavailable? How would you cope if your pharmacy could not supply your blood thinner, thyroid medicine, diabetes drug or asthma inhaler? Most of us assume that we will always be able to pick up our prescription refills. But what if the pandemic abroad leads to drug shortages in US health care facilities?
What Things Are Essential?
Many of the things we think are important turn out to be mere distractions. Computer games, political pundits and social media are not essential for our well-being. If we could no longer watch some blowhard on TV tell us why we should be upset about something, we could still manage surprisingly well.
When gasoline was in short supply in parts of the country, many people panicked. Lines at gas stations were long and unruly. People immediately tried to top up their tanks, even when they were 2/3 full.
The Old Drug Shortages in US
Most people do not realize that we have been experiencing drug shortages in US hospitals and pharmacies for years. One of the country’s leading experts on such problems is Dr. Erin Fox. Several years ago she and her colleagues wrote this (Mayo Clinic Proceedings, March, 2014):
“National tracking of drug shortages began in 2001. However, a significant increase in the number of shortages began in late 2009, with numbers reaching what many have termed crisis level…Common classes of drugs affected by shortages include anesthesia medications, antibiotics, pain medications, nutrition and electrolyte products, and chemotherapy agents.”
“Drug shortages pose a significant threat to public health and safety and have affected multiple areas of medicine during the past several years, including oncology, anesthesia, emergency medicine, and nutritional support. These shortages have resulted in delayed treatment for patients, medication rationing, and in some cases treatment being denied because of unavailability of critically important drugs.”
The New Drug Shortages in US
The old drug shortages were bad enough. New drug shortages in US pharmacies may become worse. That’s because most of our medications are now manufactured abroad.
Since the majority of dispensed prescriptions are generic drugs, we are heavily dependent upon foreign supply chains. The COVID pandemic is impacting manufacturing and shipping of such medicines.
When India Can’t Breathe Will There Be Drug Shortages in US Pharmacies?
China supplies India with a majority of the key chemicals needed to make medications. These active pharmaceutical ingredients (APIs) are often shipped to India by air cargo. Once in India they are formulated into finished drug products.
The United States is highly dependent upon China and India for essential medicines. Hospitals cannot function without key drugs made there. Many generic products dispensed from pharmacies around the country come from Indian companies such as Glenmark, Macleods, Sun Pharma, Torrent and Wockhardt.
A report by investigative journalist Anna Edney for Bloomberg (May 5, 2021) reveals that the China-India connection appears to be in trouble:
“Drugmakers in India are warning that a halt on some cargo flights from China could imperil an important link in the global pharmaceutical supply chain.”
India has been experiencing a tremendous surge in COVID-19 cases and deaths. Drug makers there are striving to maintain production despite lockdowns in some parts of the country.
The Latest COVID Stats from India:
As of May 24, 2021, India has the second highest number of COVID cases in the world. The US is # 1 with over 33 million cases. India has officially reported more than 26 million cases.
The number could be substantially higher. India now has more than 300,000 deaths linked to Sars-CoV-2. That puts it #3 in the world, behind the US and Brazil. Cases may have peaked in cities, but in rural areas they appear to be climbing.
Is the FDA Worried about Drug Shortages in US?
The acting FDA Commissioner, Dr. Janet Woodcock, told Bloomberg:
“It’s a dynamic situation. We’re going to work closely with manufacturers there. We are concerned in several ways: Will they be able to keep up production and continue to manage quality?”
Can We Trust Drug Quality?
We agree with Dr. Woodcock that quality is an ongoing concern for drugs made overseas. The FDA halted inspections of foreign manufacturing facilities shortly after the pandemic began.
In practical terms, that means that many of the drugs in our medicine cabinets have come from plants that have had limited or no FDA oversight. You can learn more about suspended inspections at this link.
Even in the best of times, the FDA has difficulty monitoring foreign drug makers. The General Accountability Office recently reported that:
“GAO has had long-standing concerns about FDA’s ability to oversee the increasingly global pharmaceutical supply chain, an issue on our High Risk List since 2009.”
Drug Shortages in US Hospitals and Pharmacies:
What would be the impact if essential medicines were no longer available? People who need heart medications, asthma inhalers, critical antibiotics or diabetes drugs might sicken or even die without access to their normal supply.
The FDA lists drugs that are in short supply but it has no authority to address the problem effectively. (See the FDA Drug Shortages list at this link.) Neither does the CDC or any other government health agency.
It’s a bit like the weather: everyone complains about it, but nobody does anything to change it. Perhaps it is time for Congress to consider addressing drug supply with incentives for quality drug manufacturing in the US. If government can sponsor vaccine research, development and distribution, why not essential medicines?
How Can You Find Affordable Medicines?
Buying prescription drugs online is tricky. How can you be sure that the pharmacy you are dealing with is reputable? That’s especially true if you are trying to save money by buying brand name medicines from Canada. We have tried to make this easier by providing guidelines and legitimate Canadian pharmacies in our eGuide to Saving Money on Medicine. You can find it in the Health eGuides section of this website.