Tuesday, September 20, 2011

Drug Supplies—Death-Causing: Plentiful, Disease-Fighting: Scarce

One of the problems with markets is that they do not always settle on the appropriate solution. Often the goals of making money and doing good are only loosely related. This has become clear in the pharmaceutical industry.
The Los Angeles Times provided us with a gloomy reminder of this when they published an article announcing that drug-related deaths in the United States now exceed deaths caused by traffic incidents.

"Fueling the surge in deaths are prescription pain and anxiety drugs that are potent, highly addictive and especially dangerous when combined with one another or with other drugs or alcohol. Among the most commonly abused are OxyContin, Vicodin, Xanax and Soma. One relative newcomer to the scene is Fentanyl, a painkiller that comes in the form of patches and lollipops and is 100 times more powerful than morphine."

"Such drugs now cause more deaths than heroin and cocaine combined."

This graphic is provided.

These are prescription drugs, but they seem suspiciously easy to acquire. On-line medical records, assuming doctors would update them, would put an end to "doctor-shopping" by addicts. However, easier ways to obtain them have arisen.

"Those prescriptions provide relief to pain sufferers but also fuel a thriving black market. Prescription drugs are traded on Internet chat rooms that buzz with offers of "vikes," "percs" and "oxys" for $10 to $80 a pill. They are sold on street corners along with heroin, marijuana and crack. An addiction to prescription drugs can be costly; a heavy OxyContin habit can run twice as much as a heroin addiction, authorities say."

There does seem to be more the medical profession could do to control access to these medications, and to control the quantities accessed.

"The rise in deaths corresponds with doctors prescribing more painkillers and anti-anxiety medications. The number of prescriptions for the strongest pain pills filled at California pharmacies, for instance, increased more than 43% since 2007 — and the doses grew by even more, nearly 50%, according to a review of prescribing data collected by the state."

While the market works just fine when it comes to providing drugs that are being used illegally, it seems to have a problem providing drugs that are needed to fight disease. We have an article in The Economist pointing out that there are serious shortages of critical medicines in the United States.

"In 2004 America had a shortage of 58 drugs. Last year it had 211 and this year 198 so far. As the problem has spread, so too has a sense of panic, with patients lacking essential medicines, doctors fretting over alternatives and hospitals navigating a ‘grey market’ for drugs."

"The shortage affects a variety of treatments, but most are generic, injected drugs. Some can be replaced by other medicines, often inferior in quality and more expensive. Others have few substitutes. Hospitals are desperate, for example, to have electrolytes that keep premature babies alive, explains Erin Fox, who tracks drug shortages at the University of Utah. Oncologists are anxious for cytarabine, a leukaemia drug."

The market issues seem to revolve around generics and the fact that competition is allowed. The Economist suggests no easy solutions, but it does make this disturbing observation.

"For now, the FDA and firms are scrounging for solutions. Eight times in the past two years the agency has allowed the import of drugs unapproved in America but used safely elsewhere. Some drugs with minor quality problems, meanwhile, are being shipped to pharmacies with warning letters. In such cases, the patient will at least receive the drug he needs. Others should be so lucky."

The only response for us is: don’t get sick, suffer through pain, and don’t be anxious. That last task is probably the toughest to pull off these days.

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