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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!
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.
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.
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.
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.
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.
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!
Usually a temporary situation, changing production sites will typically
result in down-time for the manufacturer.
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
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.
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.
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This content is intended for counseling purposes only. This content is informational/educational and is not intended to treat or diagnose any disease or patient. No claims are made as to the safety or efficacy of mentioned preparations. The compounded medications featured in this content have been prescribed and/or administered by prescribers who work with Wedgewood Pharmacy. You are encouraged to speak with your prescriber as to the appropriate use of any medication. Wedgewood Pharmacy’s compounded veterinary preparations are not intended for use in food and food-producing animals. All product and company names are trademarks™ or registered® trademarks of their respective holders. Use of them does not imply any affiliation with or endorsement by them.