Will Obama's Executive Order Alleviate Drug Shortages?
RENEE MONTAGNE, HOST:
It's MORNING EDITION from NPR News. Good morning, I'm Renee Montagne.
STEVE INSKEEEP, HOST:
And I'm Steve Inskeep.
Americans have a health care system that is huge, high-tech, innovative, expensive and that doesn't always deliver on the basics. That's a reality that President Obama sought to address yesterday.
MONTAGNE: People with cancer, infections, nutritional disorders and other problems sometimes can't get the drugs they need. There have been over 200 drug shortages in the past year.
INSKEEEP: The president issued an executive order to attack that problem. It's part of his campaign to take actions that do not require congressional approval.
NPR's Richard Knox reports on whether the order is enough.
RICHARD KNOX, BYLINE: At the most basic level, Health and Human Services Secretary Kathleen Sebelius says drug shortages are a matter of supply and demand.
SECRETARY KATHLEEN SEBELIUS: Demand for medications is growing, while capacity of manufacturing facilities has not. Now that's not something we can control.
KNOX: The government can't order drug makers to build more factories. But President Obama hopes he can get companies to give the government more notice when a shortage might be looming. That can enable the Food and Drug Administration to persuade other companies to gear up and bridge the gap. The administration is increasing the FDA's staff to deal with drug shortages, from five people, now, to 11.
Pressure to do something about drug shortages has been building over the past few months. Some of the most wrenching stories involve cancer patients who can't get the chemotherapy their oncologists prescribe.
Dr. HAGOP KANTARIJIAN: All oncologists in the United States, whether they like to admit it or not, have had patients that have been affected and may have had their prognosis become worse, or may have died from the drug shortages.
KNOX: That's Dr. Hagop Kantarijian of the M.D. Anderson Cancer Center in Houston.
But cancer patients aren't the only victims. Michael Cohen, of the Institute for Safe Medication Practices, says the group surveyed a thousand hospitals and discovered lots of different problems.
Dr. MICHAEL COHEN: We had, in some cases, anesthetics that weren't available, and they were using alternatives that the anesthesiologists weren't used to using. And there were some cases reported to us where people were waking up during surgery.
KNOX: Other patients died when they couldn't get the right antibiotic. Or when they got an overdose of painkiller, because medical personnel were unfamiliar with the dosing schedule of a substitute drug.
Cohen says a root cause of the shortages is a consolidation of companies that make old-line, generic drugs, many of them intravenous medications used in hospitals.
COHEN: We only have about five, six, maybe seven generic injection manufacturers that are still out there. Whereas, before we had probably scores of them.
KNOX: So when one company's production line goes down, the remaining suppliers can't take up the slack. Some middle-men are quick to take advantage of the shortage. They scoop up the available supply and raise the price by three- and 4,000 percent.
The president wants the Justice Department to look into that kind of price-gouging.
The reason so few companies are interested in making these older drugs in the first place, is that there's not much money in it.
COHEN: That has absolutely been a reason that some of the manufacturers have stopped making a product. It just hasn't been profitable enough.
KNOX: That's a tough problem to solve. Most countries control the price of drugs. They keep the price of generic drugs higher, and they cap the prices of brand-name drugs. That makes the generics more attractive to make. Price controls don't seem to be in the cards here, so the Obama administration is trying to manage drug shortages better.
Administration officials acknowledge that might take more than a presidential order. They say they need legislation to require drug makers to warn them when a shortage might be coming.
Richard Knox, NPR News
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