Blame drug makers for ER shortfalls in caring for patients in ‘trauma season’

As the nation struggles through the “100 deadliest days,” the summer season of medical traumas, hospitals are warning anew that they’re not faring well in their constant battles to stock drugs that patients need for their care, notably in emergency rooms.

The New York Times reported that ERs across the country can’t find and keep sufficient supplies of vital medications, ranging from “morphine, which is used to ease the pain of injuries like broken bones [to] diltiazem, a heart drug.” And said the newspaper story:

Hospitals small and large have been scrambling to come up with alternatives to these standbys, with doctors and nurses dismayed to find that some patients must suffer through pain, or risk unusual reactions to alternative drugs that aren’t the best option.

Drug shortages aren’t new or uncommon. But ER experts have expressed concern (see info graphic) how they’re harming patients more and more directly, the newspaper reported:

A survey in May of emergency doctors by their professional association, the American College of Emergency Physicians, found that 9 of 10 said they didn’t have access to critical medicines, and nearly 4 in 10 said that patients had been negatively affected.

As always, Big Pharma’s profiteering practices should shoulder considerable blame. The drugs that hospitals need but can’t get are less costly and companies that make them reap good profits. But that isn’t sufficient for an industry that’s always seeking an even bigger buck, notably through new and exotic products that serve smaller slices of the market. So, fewer firms make more common drugs. This can mean any disruption in the supply-chain fast turns disastrous. As the newspaper reported:

The vast majority of the products [in short supply] are sterile injectable drugs, hospital workhorses that are cheaply priced even though they can be difficult to make. These low margins have led some companies to stop making the drugs, while others have failed to invest in older facilities, leading to a host of quality problems, recalls and plant shutdowns. The periodic problems were compounded last fall when Hurricane Maria hit Puerto Rico, a major center of pharmaceutical manufacturing, causing a shortage of small saline bags that are a mainstay in hospitals and worsening a years-long problem with keeping intravenous fluids in stock. But even as that crisis subsided, hospitals began grappling with the aftermath of another industry cataclysm — serious manufacturing problems at Pfizer, the nation’s largest maker of generic injectable drugs.

The federal Food and Drug Administration has chased Pfizer over quality issues at one of its major manufacturing sites, including one in McPherson, Kans. Pfizer said it acquired that facility in an industry deal and has been forced to make major upgrades. It has apologized that it has listed hundreds of drugs that will be hard to get as it races to address FDA concerns and invests in improving its manufacturing centers.

Competitors also have not been able to step up and in. The FDA has allowed Pfizer, due to shortages, to sell some products the agency normally would recall, the New York Times said.

This is not good. In my practice, I see not only the harms that patients suffer while seeking medical services but also their struggles to access and afford safe, effective, efficient, and even excellent medical care. I see them slammed not only with skyrocketing costs for medications they need but also by the havoc wreaked on them by dangerous drugs.

In his election campaign, President Trump barked at Big Pharma, declaring he would help patients deal better with drug makers and their exorbitant pricing and exhausting games-playing with demand and supplies of their products. Since taking office, and especially since a closed-door meeting with Big Pharma CEOs, Trump has acted more pussy cat than industry watchdog, and his ballyhooed cost cuts haven’t materialized.

Even as some frustrated hospitals have said they may respond to various drug supply and cost issues by getting into the manufacturing end themselves, Trump, the FDA and Alex Azar, the head of the giant, federal Health and Human Services, have announced initiatives purportedly targeting drug supplies and costs. But patients haven’t got much to show for all the talk. Trump recently made one of his silly statements on how he knew of imminent and significant drops in drug prices. Media organizations, perhaps to some excess, have kept him accountable for that comment.

Let’s not get distracted, though, by gotcha coverage. Instead, let’s stay focused on how someone, sometime needs to rein in Big Pharma. Just look at Pfizer, for example, which is leading the sector as various of the drug makers their annual mid-year price hikes. There goes Big Pharma again, jacking up prices without a care.

Patients, of course, do. A lot. In the months when vacations and travel and care-free attitudes take hold and many of us not only spend a summer at leisure but also in accidents and mishaps that require trauma treatment, none of us should be forced into extra agony or other harms because needed, profitable drugs aren’t available for us, our kids, loved ones, and friends. This shouldn’t, of course, be the case at any time of the year.

But maybe the alarms sounding about ER care will get some of our leaders, politicians, and policy makers off their cushy backsides and to do more, much about Big Pharma and its venality.