Medicines: the new endangered species

Remember all the talk about supply chain shortages due to the COVID pandemic shutdowns? Then suddenly there is nothing in the mainstream news. Are supply chain shortages a thing of the past?

Far away. There are supply chain issues, and one in particular could have devastating consequences. Some medicines are in short supply. Between 2021 and 2022, drug shortages increased by 30 percent. By the end of 2022, almost 300 medicines were on the shortage list.

Medicines on the endangered species list

In particular, some antibiotics are nowhere to be found. Shortages of the commonly prescribed broad-spectrum antibiotic amoxicillin have been reported in the United States for more than six months. This drug is the number one prescribed antibiotic in the United States and is used for ear infections, pneumonia, and all sorts of things. Formulations commonly used for children (liquid suspension and chewables) are in the shortest supply. Patients tell stories of having to go to four or five different pharmacies just to fill these prescriptions.

Injectable drugs experience the worst shortages; an example is propofol, a sedative used by anesthesiologists before surgery. Another example is methotrexate, used to treat inflammation caused by arthritis and psoriasis. This is best explained when one realizes that 95% of our injectable drugs in the United States rely on raw materials from China or India. A national shortage of the asthma drug albuterol was reported in March and is now getting worse. The drug Adderall, used to treat ADHD, is in short supply, as is the drug Ozempic, a type 2 diabetes treatment.

Chemotherapy drugs are one of the main drugs that suffer from shortages. Nearly 25 front-line cancer treatments are in short supply, fueled by “expanded demand.” Could demand be from turbo-charged cancers fueled by the shocks of COVID-19? Interestingly, many of the drugs are used to treat pediatric cancer patients. Is there a common thread here?

The result is delayed or denied treatment and ultimately a shorter lifespan. A key predictor of patient outcomes is getting the right dose on the right schedule, as described in an example study published in 2020 showing that a one-month delay increased the risk of death by up to 13 per cent.

Some pharmacies report severe limitations, such as one bottle per pharmacy per day, while other representatives, such as those at CVS, say there are no problems and everything is fine. The FDA reports on the shortage, but the drug is not listed if at least one manufacturer can supply it, so this report is somewhat misleading to say the least, because this does not mean that the national needs are covered. The FDA is mum on the matter, assuring us that while there are some isolated problems in the supply chain, everything is fine.

National security risk

The US Congress thinks it’s so bad it’s a national security risk, and the Senate Homeland Security and Governmental Affairs Committee is holding meetings, drafting reports, and probably writing stern letters as we speak.

Congress is a little late to the game, as is often the case. This has been a catastrophe in the making for a long time. For at least a decade, many patient advocacy groups have urged Congress to implement long-term solutions. Why haven’t they done it? I think we all know the answer.

What are the drivers of this shortage?

Most often, we are told that “the authorities are not sure what is causing the shortage.” Really? Are you saying there is no one in our bloated federal government who can answer that question? FDA maintains shortage database; Can’t the FDA answer this question? Why Can’t the FDA Adequately Predict Drug Shortages? Can no one in private industry answer that either? The American Society of Health-System Pharmacists maintains a drug shortage database similar to the FDA. Can they answer the question? What about big pharma? Can they answer the question? Maybe all these entities can, but they just don’t talk.

If given a reason, a common theme is the “unprecedented demand” for certain drugs during the Covid-19 pandemic, but the “unprecedented” narrative of COVID-19 is wearing thin, and it’s even more complicated than this

The US is heavily dependent on foreign suppliers in India, China and other countries. In fact, many US drug manufacturers have operations abroad; these movements have occurred over several decades. Foreign countries offer lucrative incentives, such as far fewer regulations, the ability to control the entire supply chain from initial ingredients to finished product, and huge tax incentives.

I mentioned the amoxicillin shortage above, and none of the top three manufacturers of amoxicillin are based in the United States. Hikma Pharmaceuticals is in the UK, Sandoz is in Switzerland and Teva is in Israel. All report shortages of amoxicillin.

Congress now views dependence on China as an unacceptable national security risk. why now We have trusted China for many years. As an aside, remember when President Trump brought manufacturing back to the US? Just saying’.

Trump said: “Everybody does our drugs but us.” He said he could reduce America’s dependence on China’s drug manufacturing within two years. The strain on the US health care system during the COVID-19 pandemic highlighted our dependence on China and other manufacturers. In particular, China has a dominant position in the creation of active pharmaceutical ingredients (API). Three years ago, in May 2020, industry experts feared the outbreak would create severe drug shortages in the US. They were right. In fact, many Western countries such as Japan, Germany and France depend on imported drugs. All these countries, including the US, have lost the ability to produce many basic medicines.

Never fear, Congress to the rescue

Congress recommends that the heads of the Departments of Defense, HHS, and Homeland Security conduct a comprehensive supply chain risk assessment. But will they actually do anything, or just write sternly worded letters to each other? Not to be outdone by Congress, Biden tapped HHS Secretary Xavier Becerra to head an advisory board to investigate the underlying causes of the shortage. The first thing Becerra said was that the shortage is due to “ongoing Covid-19 supply chain issues.” This is patently false. We’re not buying it. And by the way, since you already gave the conclusion, this may be the shortest advisory board ever. Problem solved!

The current shortage in the United States is being described as the “biggest drug shortage crisis in modern history.” Will our Congress act, or is it too late?


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Fed Up Texas Chick is a contributing writer for The Tenpenny Report. She is a rocket scientist turned writer, having worked in the space program for many years. She is an experienced medical writer and researcher who fights for medical freedom for all of us through her work.

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