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Not Enough to Swallow

By milhayser on March 1, 2012.

On Denialism Blog, Mark Hoofnagle writes that a wide array of drugs, from antibiotics to steroids to diuretics and chemotherapeutics, are in short supply around the country. Hoofnagle explains, "The drugs affected span all classes, what they have in common is they are all generic." Because of the low profit margin on generic drugs, "manufacturers try to cut costs where they can, they export production abroad (and away from FDA oversight), and keep supplies low." Quality suffers, and with only a few companies producing certain drugs, disruptions can have far-reaching (and deleterious) effects. Should government subsidize the manufacture of generic medicine, or take it away from the free market? On Respectful Insolence, Orac covers a far simpler course of treatment: wishing, and hoping, and thinking, and praying. New studies show that alternative medicine is no more effective than a placebo, but one advocate says the placebo effect is proof of the Law of Attraction. Maybe surgical patients can just visualize more anaesthetic? Finally, Abbie Smith cannot believe that the FDA has granted expedited approval for a daily pill to protect against HIV infection. Smith writes that in large clinical trials, "Tenofovir didnt work well at all [...] There is *no* experimental evidence to suggest that is a good idea right now." The drug could actually lead to more new infections—and cause permanent kidney damage.

Tags
hiv
Pharmaceuticals
wishful thinking

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The government should stockpile essential meds and do it with an eye toward stabilizing markets and moderate prices, eliminate shortages, and maintain sufficient stocks to deal with large scale disasters. I suspect that a market that was made more stable and regularized would be attractive to generic drug manufacturers as wild fluctuation are disruptive to low margin businesses.

We already do this, to some extent, with the Strategic Petroleum Reserve. The intent in both cases would be to knock the edges off any major price or supply shock and to have enough on hand to handle national emergencies.

A Fukashima scale event on the west coast could easily fill every hospital bed and see shortages of even the most basic medications.

Does this mean iatrogenic deaths are about to go down?