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Unprecedented drug shortages and upset veterinarians

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Upset veterinarians

Originally published in 2012 on this blog

My colleagues and referring veterinarians trying to treat their patients with certain medications are upset. When I speak with them, they ask me questions about these medications like, “What happened to ...?,” “Where do I get ...?,” “What do you use to treat ...?” There are severe and numerous medication shortages right now that appear to be inexplicable, frequent, and irritating!

To make matters worse, I recently received a message from a drug manufacturer announcing another round of what can only be described as “breathtaking” price increases for a long list of items. The price changes were effective immediately and they even asked me to help communicate this to my clients so that they would be aware of the new pricing and not be shocked when the order arrives. The price increases on individual items ranged from a 11% increase to a 963% increase!

Unprecedented drug shortages

The nation is facing unprecedented drug shortages. From cancer treatments, surgical sedatives, intravenous medications and many emergency-room remedies, the pharmaceutical supply chain is under duress. Industry consolidation, manufacturing problems, and economic strain have strangled the pipeline that supplies medications for hospitals, physicians and veterinarians. The shortages are more frequent and prolonged.

Many of the shortages are generic drugs. There are fewer manufacturers of such medications and profitability is shrinking. Any breakdown in manufacturing or shortage of raw materials can cause a widespread medication shortage. The FDA cannot order manufacturers to make more drugs. It can accelerate the approval process or in certain cases allow nonlicensed drugs from overseas similar to the scarce drugs be used in urgent situations. Typically, distributors have a two to three month supply in stock.

Top Seven Reasons That Drugs Go On Backorder

There are a number of reasons why a drug goes on backorder. I've outlined the seven most-common issues affecting your access as a prescribing veterinarian to the drugs you need.

Mergers

Any time you read the papers you hear about pharmaceutical companies acquiring each other and merging into fewer and fewer entities. A side effect of this is that some drugs are not viewed by the new company as important or profitable and can be discontinued for this reason alone.   

Factory closings     

Whether it is forced or voluntary, some pharmaceutical manufacturers need to close certain plants for simple maintenance or even safety issues. When this happens, any drug they were producing there is suddenly no longer in production, even though there may be nothing wrong with that drug.              

Raw material shortage

When a chemical supplier has its own issues getting raw chemical or distributing it to the manufacturers, it has the effect of slowing or halting production of the drug. Veterinarians are frequently blind-sided by occurrences like these, because they often cannot be predicted, and word of the shortage at this level doesn’t spread until it’s too late.       

Increased demand

There are more prescribers and more patients today than ever. Simple economics proves that this puts a strain on the ability for everyone to get the manufactured drugs they need when they need them. An issue like this, however, is typically resolved by an increase in production at some point, but may result in price increases!               

Change in production site

Usually a temporary situation, changing production sites will typically result in down-time for the manufacturer.

Product discontinued   

Products can be discontinued for any number of reasons from safety concerns to low sales. No matter the reason, the impact is always the same: drugs you need in your practice are no longer available!              

Recalls

When drugs are recalled, it creates an instant headache for you. Sometimes, it’s a single lot that gets recalled and the disruption is minimal, but occassionally, the drug is subsequently pulled from the market altogether.        

About Michael H. Brown, DVM, MS, Diplomate, ACVO (Ophthalmology)

Michael BrownDr. Brown received his Doctorate of Veterinary Medicine from Kansas State University in 1992 and then performed a small animal internship at the Animal Medical Center in New York City. After returning to Kansas State University for a comparative ophthalmology residency, he received a Master of Science degree for his biochemical study of animal tears. Dr. Brown became a Diplomate of the American College of Veterinary Ophthalmologists in 1996, when he started the ophthalmology practice in Little Falls, NJ. Dr. Brown’s special interests include diseases of the cornea, corneal surgery, intraocular surgery, diseases of the retina, ophthalmic photography and the role of oxidative stress and nutrition on diseases of the eye. He has written numerous scientific papers and is a noted national lecturer throughout the country, providing veterinary ophthalmology continuing education for veterinarians and technicians. Dr. Brown consults closely with research organizations to help improve ocular health and vision in animals and people.