This front-page article in Friday’s New York Times is alarming, to say the least.
The short summary: While drug shortages are the “new normal” in American medicine, the resulting rationing has been “largely hidden from patients and the public.”
The American Society of Health-System Pharmacists currently lists inadequate supplies of more than 150 drugs — including anesthetics, painkillers, antibiotics and cancer treatments — and therapeutics, for reasons ranging from manufacturing problems to federal safety crackdowns to drugmakers abandoning low-profit products, the paper says.
And at medical institutions across the country, choices about who gets drugs often have been made in ways that have resulted in contradictory conclusions, murky ethical reasoning and medically questionable practices, according to doctors, hospital officials and government regulators.
An international group of pediatric cancer specialists became so concerned about the profession’s unsystematic approach to distributing scarce medicine that it’s developed rationing guidelines that are being released Friday in The Journal of the National Cancer Institute.
A Cleveland Clinic pharmacist says children haven’t gotten priority over adults during chemotherapy shortages. But at other hospitals, they have, because of their potentially longer life span or because they sometimes need smaller doses of a drug.
In another example of rationing decisions, obese patients, who researchers found needed up to three times the amount of an antibiotic before surgery than average-size patients, were given only the standard dose at the Cleveland hospital until a shortage abated.
An anesthesiologist who, with colleagues, surveyed patients at Mayo clinics, says he was surprised that most wanted to know about a drug shortage that might affect their care during elective surgery, even if there was only a minor difference in potential side effects, and many said they would delay surgery.
“Doctors and hospitals often do not tell patients about shortages and the resulting rationing because they do not want them to worry, especially when alternative drugs are available, or because they feel it would stir up too much anger,” says the Times.
No, kidding. I’m sitting here angry. This is a problem caused by humans, and we can fix it and save people’s lives. If we muster up the will.