r/news May 27 '23

As cancer drug shortages grow, some doctors are forced to ration doses or delay care

https://www.nbcnews.com/health/cancer/cancer-drug-shortages-14-medicines-now-short-supply-fda-says-rcna86106
12.3k Upvotes

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u/djarvis77 May 27 '23

Second line of the Title

Fourteen cancer drugs are in shortage, according to the Food and Drug Administration.

They then go on to not list the 14 cancer drugs in shortage.

I really don't care all that much, but it is frustrating that they set up a very obvious question (Which drugs are in short?) and then don't fucking answer it.

Here is the FDA drug shortage list obviously it goes way beyond the fourteen cancer drugs, but since i was only wondering about the one my pop is on, the list was helpful.

I just don't see why news articles don't link to the actual sources of their info. Instead they link to themselves. It's weird.

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u/[deleted] May 27 '23

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u/aabicus May 27 '23 edited May 27 '23

The article that recently topped reddit about the US giving away free lighthouses did it too. Just said "they're giving away 10 lighthouses" and didn't list them

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u/Maximum-Mixture6158 May 27 '23

I need to get on better reddit mailing lists

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u/[deleted] May 28 '23 edited Jun 30 '23

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u/dweezil22 May 27 '23

This is such a frustrating issue with local and state politics. You'll see 3000 words written in a news article and 100K words of social media comments spilled to discuss a 500 word bill where almost no one read the bill (and it turns out the bill doesn't do what 99% of the commenters thinks it does; hell often the legislators don't all even know what it does, it only becomes clear after it passes). I'm mostly of the Hanlon's Razor view for these.

In instances where $ is at stake it's more reasonable to be a bit conspiratorial, but oftentimes it's just that the article writer isn't great at describing things succinctly and commenters are just dumb and eager to argue.

Case in point: There was a Maryland law that sought to avoid giving visitation rights to rapists that parented children. Men's Right's types were all eager to argue that this was evil and skipped due process ("omg ex wives are going to claim rape!"), no one noticed that the law in question required a judge to actively revoke the rights after coming to a clear conclusion that the rapist had no legitimate familial relation with the child (i.e. it would only be applicable in a stranger/date rape type scenario and only then after serious review)

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u/THEBHR May 27 '23

no one noticed that the law in question required a judge to actively revoke the rights after coming to a clear conclusion that the rapist had no legitimate familial relation with the child (i.e. it would only be applicable in a stranger/date rape type scenario and only then after serious review)

I find it much more fucked up that they were going to give parental rights to a person who rapes a family member. (If I understand you right)

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u/dweezil22 May 28 '23

This is the poster case: Robbie Rapist hides in the bushes and rapes Victim X. Victim X becomes pregnant and gives birth to a baby. Robbie is arrested and jailed, as he should be.

Robbie, being a truly sadistic monster, exercises his legal rights to demand visitation rights with the child (he's still in jail, but parents have a right to fight for this, even in jail). Victim X must now hire a lawyer and deal with the horror of the government forcing the Victim to allow the rapist to see her child. Robbie will probably fail, but the entire ordeal is already terrible for Victim X and her poor child.

This was never legislated directly, it was an unintended overlap between rape laws and parental rights laws. The fix is to allow the courts to proactively throw out the rights of rapists (but that fix got Mens Rights ppl's panties in a twist b/c they didn't read the law).

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u/[deleted] May 27 '23 edited May 27 '23

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u/ItsTricky94 May 27 '23

thank you for posting this. I didn't even realize that one of the chemo medications I am on for Rheumatoid Arthritis is in shortage. I am very fortunate that it's not a matter of life and death for me if i could not get it (debilitating pain, yes, but I would still live without it) but my heart breaks for those in these dire situations. 💔

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u/LizbetCastle May 27 '23

Is it the kind of thing that can do damage if left untreated? I have chronic pain but not RA and I hope you can keep getting your prescription. The psychological effects of always hurting are uhhhhhhhhh bad.

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u/GiveMeCheesePendejo May 27 '23

Not having access to medication for RA can cause extremely painful flare-ups and significantly decrease the quality of life of the person who has it.

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u/Fake_Engineer May 27 '23

Untreated RA caused me to need a knee replacement in my 30s.

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u/smallangrynerd May 27 '23

Yup. I also have RA but my medication is not on this list thankfully. The inflammation of RA can eat away at the bone in your joints, causing osteoarthritis.

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u/missyanntx May 27 '23

I have an auto immune disease, granulomatosis with polyangiitis. It's on the less common side of auto immunes so they throw the RA drugs at us. The RA drugs (and there are a variety) do work for this so it's all good. The specific drugs I use aren't on the list thankfully.

Back to "but did you die?" In the case of my disease, untreated it is a killer. I'd likely bleed out from my lungs or kidney failure. Well specific to me, I would have asphyxiated. It attacked my trachea and when I went in for surgery to release the scar tissue and dilate my trachea I was down to about 35-40% of the diameter I should be. From the time I started feeling ill to dx was five months. Seven months into treatment is when I had surgery. My trachea was not noticeably constricted when I was dx, that happened while the docs were throwing drugs at me trying to get it under control.

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u/bihari_baller May 27 '23

In the case of my disease, untreated it is a killer. I'd likely bleed out from my lungs or kidney failure.

That has to be scary, to have your life dependent on the supply of medicine you need.

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u/IOVERCALLHISTIOCYTES May 27 '23

People w long untreated or nonideally treated rheumatoid arthritis can sometimes be spotted just by their hands across the room. Absolutely the damage stacks.

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u/skib7542 May 27 '23

I'm on 3 different medications for my RA and 2 of them are on this list... Now I'm worried

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u/ItsTricky94 May 28 '23

don't freak...double check with your doctor to find out what alternatives there are in case this becomes an issue. honestly I didn't even know about my MTX shortage until I saw this. If it were really bad i think my doctor would've alerted me. hang in there.

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u/Maximum-Mixture6158 May 27 '23

If it does happen, check in with other types of pharmacies. I've had to do that for my meds.

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u/LaLucertola May 27 '23

The ADHD medication shortages are wreaking absolute havoc on patients lives, most of us that take these meds need them to keep our lives from falling apart. It's been in official shortage since October, with issues dating back to almost a year ago, and there's so little urgency from anyone to do anything about it.

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u/[deleted] May 27 '23

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u/[deleted] May 27 '23

I think my psych encourages me to skip my adderall on the weekends to build up a reserve in case this happens. I don’t know what’s up, but my pharm hasn’t had a shortage.

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u/[deleted] May 27 '23

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u/OrkBjork May 27 '23

My psych encourages the same thing. I'm also chronically sleeping so I often miss my morning dose and that helps if i have to wait for it.

I don't know if it's just my area, which is pretty suburban to rural, but I had mine filled the other day and my psych put it in at like 9am and it was ready by noon. I think some areas are serving way more patients than others and that seems pretty unfair or at least inefficient.

Like it's nice I got it same day but I wonder if they have a surplus and the more densely populated areas have days or weeks wait times. Feels like there's supply available, but its distributed unevenly to the populations needs. It's just anecdotal observation though and I wouldn't know how logistically feasible it is to distribute appropriately or what the obstacles are

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u/ScarletPriestess May 27 '23

I am on a narcotic that has been having supply issues for a couple of years. Anytime my regular pharmacy can’t get it in for my monthly fill I call other pharmacies near me to find out if they have any in stock. I have never had any of the pharmacies refuse to tell me. This is not the first time I’ve read about people not being told if their medication is in stock and it just confuses me.

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u/Johns-schlong May 27 '23

Man, it's almost like the free market doesn't solve every issue.

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u/enduhroo May 27 '23

Uhh, this is not a free market.

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u/TrashyTrashPeople May 27 '23 edited May 27 '23

Good pickup, it's one of the reasons I liked reddit so long ago, additional information in the comments.

Anyway, this seems to be a concerning trend that I first noticed with adhd medications, there's been a shortage for months now, with conflicting statements from organizations that are supposed to regulate or oversee it.

This is just a fine example of how some things shouldn't be businessified/corporatised, and that businesses/corporations require regulation and auditing*/inspection (there's another word i want to use instead of inspection but I can't think of it, accountability is part of it). (And also an example for why some organizations need to be dissolved and abolished... I'M LOOKING AT YOU DEA)

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u/Cu1tureVu1ture May 27 '23

Is the adderall shortage still going on?

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u/courtezanry May 27 '23

yes, and Ritalin and Concerta (time release Ritalin) is now affected. I have to call around, I was on Concerta and I have to take Ritalin now. at least I have something, but it's BS.

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u/tiggahiccups May 27 '23

It’s an effing joke. I can only tolerate one medication out of all of them and the dr has tasked me with the job of calling around to find it. I have fuckin adhd, COME ON. I have only managed to contact two places and neither had it.

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u/6SixTy May 28 '23

It's even worse if the pharmacy denies telling you, a member of the public, if they have stock due to schedule 2 rules.

When Adderall went into shortage, I thought I was fortunate to be on the other camp, but I should have seen it as a warning sign.

I got lucky today though.

Wish KenPharm/Zevra/Corium would just start making their new stuff (serdex...) instead of making a combined med since it's not regulated as Schedule 2.

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u/Minerva8918 May 27 '23

You actually get an answer on if they have the meds in stock? I take Adderall XR (generic) and every place says they need the rx in their hand to check if they have it.

It's fucking ridiculous. I understand why in normal circumstances that could be problematic, but they could at least say if they DON'T have it.

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u/Beautiful_Welcome_33 May 28 '23

There are alllll sorts of drug shortages currently going on.

Everything from cancer meds, to corticosteroids to stimulants to hormones and complex biologics.

It's made worse by iur health care systems byzantine administration and incredibly slow, bordering on nonexistent, response time to crises.

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u/[deleted] May 27 '23

there's another word i want to use instead of inspection but I can't think of it, accountability is part of it

Auditing? Oversight?

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u/TrashyTrashPeople May 27 '23

AUDITING thank you!

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u/djaun3004 May 27 '23

Especially when there's a lot of money to be made from a crisis shortage.

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u/actuallyrose May 28 '23

I was pretty shocked that we were just out of infant Tylenol and Motrin for months and like…no biggie! On top of the formula shortage. And there’s no global disaster or shortage of a key ingredient. We just literally cannot get our shit together to make medicine now, I guess.

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u/flannelback May 27 '23

Also, they didn't mention that the main supplier is in India, which was the second question that came to mind for me.

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u/mindspork May 27 '23

What you think a US insurance company would pay the price for it if it was made domestically? There's no profit in that.

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u/djaun3004 May 27 '23

There's profit. But there's not enough profit for the billionaires who decide what's enough profit.

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u/steveosek May 27 '23

India is one of the world's leading producers of generic medications. They make most of them actually.

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u/geek180 May 28 '23

I think most of the world’s medication come from India and Pakistan. It’s not like just the US companies have cheapened out and taken drug manufacturing overseas. The whole world is relying on these places for drugs.

It could also probably be argued that it’s simply easier to setup large-scale drug manufacturing in these places.

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u/steveosek May 28 '23

They do. I worked for a pharmacy, almost everything not name brand came from India or Israel. India more than anything else. They're the largest producer of generic medications(India that is).

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u/[deleted] May 27 '23

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u/meese699 May 27 '23

From that list I have taken Azacitidine, Cytarabine and Fludarabine which are cancer drugs used for Leukemia treatment. Cytarabine is the Frontline treatment for it

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u/CharleyNobody May 27 '23

I’m seeing all over internet “Neuralink brain chip ok’d for human use by FDA.” But I’m not seeing any press release from the FDA confirming this. With Elon Musk’s history of lying, why aren’t journalists doing the most basic research and asking, “When did the FDA approve this? They denied use of it in humans in March 2022. Where’s the FDA announcement they gave gave go-ahead?” It’s unbelievable.

https://www.reuters.com/investigates/special-report/neuralink-musk-fda/

From link:
On at least four occasions since 2019, Elon Musk has predicted that his medical device company, Neuralink, would soon start human trials of a revolutionary brain implant to treat intractable conditions such as paralysis and blindness. Yet the company, founded in 2016, didn’t seek permission from the U.S. Food and Drug Administration (FDA) until early 2022 – and the agency rejected the application, seven current and former employees told Reuters.

Journalism is dead.

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u/SNRatio May 27 '23

The articles aren't about rejection/approval of use of the device, the articles are about rejection/approval of performing a study in humans: the next step for them to eventually get it approved for use as a medical device. The FDA rejected Neuralink's application last year, but approved it this year. Approval of the device for medical use is still years away (if ever).

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u/bpastore May 27 '23

While this is true, most of the articles are still, at their core, more hype than journalism -- and it is definitely what the corporation hoped to achieve by announcing that the FDA approved clinical trials without providing the scope of what those trials are permitted to test.

So these clinical trials could be very small scale preliminary trials for a use that is not particularly dangerous or based upon a medical procedure / use that is not remotely groundbreaking... or it could be to test a new method of applying completely bleeding edge technology within the brain.

If the journalists cared about the integrity of the story, they would confirm something beyond the initial press release from Musk's company. But that gets way less clicks so, people can be easily misled into believing this is far more newsworthy than it might be.

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u/SquirrelAkl May 27 '23

Far out. An 11-page list of drugs in shortage?? What the heck is going on with these pharma companies?

I noticed Estradot isn’t on the list (obvs not a cancer drug, but it is in global shortage and the list covers a whole range of things), so I wonder how severe the definition of “shortage” is?

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u/WeWander_ May 27 '23

Cool the benzo I take daily is on there. Hope that doesn't cause any issues since I can't really go without it.

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u/MC1065 May 27 '23

I just don't see why news articles don't link to the actual sources of their info. Instead they link to themselves. It's weird.

As a journalist I can say it usually comes down to two reasons. First being that the names of the drugs in question might not be the real point of the article, which I know sounds completely absurd but often we're focused on analyzing the implications of things rather than the thing itself. And incidentally, they do name one of the drugs in question as an example, because it's conducive to telling the story. We're not writing research papers or essays, though as a person who has done a research intensive degree sometimes I am annoyed at the lack of citations in articles.

Also, publications really like linking to themselves for views obviously. Personally I link to external websites plenty, but I am required to link to other articles on the website I write for. This is another thing that can get in the way of tracking down background info if you're trying to research the story yourself.

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u/djarvis77 May 27 '23

I know sounds completely absurd but often we're focused on analyzing the implications of things rather than the thing itself. And incidentally, they do name one of the drugs in question as an example, because it's conducive to telling the story.

Thanks for the interesting reply, and i appreciate your take on it and the explanation.

That part above is where i get annoyed at journalism. I understand why it is done that way...but for me, i don't want a story, i don't want an implication laid out. Or rather, i want both. The full info, the complete info (the name/number of the legislation, the number of votes, the names of the 14 drugs...). For me, the story comes afterward. The implications being laid out is not as important as the info.

Part of the issue with implications is, that is where some people tend to drift into fiction or hyperbole. Most don't, but those that do, they do it with gusto and that gets problematic.

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u/MC1065 May 27 '23

Well there are only so many words you can stuff into an article before it becomes too long, and most people don't want all that info. Someone could come along and write a more complete analysis but for a typical article, it has to be a certain length. And yea, trying to tell a story is a delicate thing and can overlook the facts for the sake of the narrative. It does hurt to shelve an article after you do the research and realize your idea isn't all that great, but that's what you gotta do.

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u/ajtrns May 27 '23

neither of these are good or persuasive reasons. please be the change! journalism SHOULD BE research. there's no word limit now. no limit on references. it DOES NOT add to the story or the reader's understanding of the world to hide information. it DOES call into question the skill of the journalist and the trustworthiness of the publication when they have a widespread policy of subtracting obviously useful information.

"real point of the article" -- there is no "real" point if the reporting is so shallow. there is only a notification of a happening, so frustratingly cursory that it can't be trusted.

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u/unholyswordsman May 27 '23

Thank you for helping us get more info. I hope this gets resolved. I'm supposed to start taking one of the drugs on that list soon.

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u/heyitsmekaylee May 27 '23

I can answer slightly (work in cancer). There’s a platinum shortage, and a good chunk of Chemos have it in it. Carboplatin being one, which is used for different cancers.

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u/Bluest_waters May 27 '23

why is there a platinum shortage?

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u/thesdo May 27 '23

Supply is basically flat, but demand is way up driven mostly by industrial usage.

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u/yippee-kay-yay May 27 '23

Also, the war took out the second largest producer of it, as well

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u/PixelizedPlayer May 27 '23

Supply is basically flat, but demand is way up driven mostly by industrial usage.

A lot of platinum came from Russia the war has caused issues due to sanctions.

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u/[deleted] May 27 '23

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u/agangofoldwomen May 27 '23

If only the sun shined bright and the wind blew strongly in South Africa… they could use renewable energy. Sadly, they HAVE to use coal. There’s simply absolutely 100% no way around it.

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u/tyleritis May 28 '23

Seriously though, I swear the sun shines brighter in South Africa more than anywhere else I’ve been on earth

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u/agangofoldwomen May 28 '23

It’s quite literally one of the best places on earth for renewable energy.

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u/Bluest_waters May 27 '23

demand is up, why though?

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u/Barabasbanana May 27 '23

Russian sanctions, electricity problems in South Africa, closure of some mines due to overproduction etc etc

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u/[deleted] May 27 '23

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u/Bluest_waters May 27 '23

ah! excellent, thanks for the great answer!

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u/[deleted] May 28 '23

Many reasons, but titanium and platinum are 2 metals we need for everything, and Russia was/is a player in it (in fact they are a player in lots of natural resources). It can still be sourced and all, but Russia is gonna charge the "fuck you" tax or you it would need to be sourced through a middle man like india which would have its own problems (this all assumes we set aside all the rules involving the trading traffis and bans).

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u/iceberg May 27 '23

Good call. Cisplatin is also on the list and standard of care in some tumors. Hope the shortage is resolved quickly.

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u/newleafkratom May 27 '23

...“Unfortunately, the profitability of this industry is very low or
nonexistent,” Califf said. “A number of firms are going either out of
business, or they’re having quality problems because of difficulty
investing in their technology. That’s the core underlying reason for the
shortage that we’re seeing.”...

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u/torpedoguy May 27 '23

We've seen what happens to budgets when something gets 'acquisitioned', it's not surprising they'd go out of business. Remember what happened to Toys'R'Us and other vulture-firm victims?

"This new company we just bought only has double-digit percentage margins. Drain their assets into this other asset we have, say the prices just weren't high enough or whatever. See if you can get a bailout while we're there."

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u/RexIsAMiiCostume May 27 '23

Adderall, and now other ADHD stimulants, are also in short supply. For a while, Ozempic, and then other similar drugs, was on back order. It's been a rough time at the pharmacy where I work :(

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u/[deleted] May 27 '23

Adhd meds are purposely restricted by the DEA.

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u/RexIsAMiiCostume May 27 '23

And people have had a very difficult time getting their prescribed medications

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u/wonwoovision May 28 '23

yep in the past six months i've been able to get mine only for three of those months. the brain fog and fatigue is genuinely debilitating and if my boss wasn't so understanding i'd likely be out of a job.

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u/KayakerMel May 28 '23

Ozempic and Wegovy are both still on the shortage list. Wegovy's manufacturers says the shortage will last until September at the earliest.

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u/RexIsAMiiCostume May 28 '23

We've had no trouble getting them, but we are a pretty small pharmacy so we don't need that much

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u/[deleted] May 27 '23

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u/FerociousPancake May 27 '23

As a son who just lost his father to cancer earlier than what could’ve been because he didn’t want to pay over $10,000/mo for targeted medication this pisses me the fuck off

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u/WaXXinDatA55 May 27 '23

Man first off I’m so sorry for your loss and secondly I’m absolutely fucking terrified cuz my dad just very recently got diagnosed with cancer.

FUCK CANCER!

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u/FerociousPancake May 27 '23

I appreciate it. For the cards he was dealt, he did have the ending that he wanted and was surrounded by family and passed comfortably. Cancer is an absolute roller coaster of emotions. I hope your dad is able to fight and get the support he needs and deserves.

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u/WaXXinDatA55 May 28 '23

That truly means a lot, thank you and much love my friend👊💙

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u/TroodonsBite May 27 '23

As a pharm tech in a hospital, the shortages have been insane. We’re literally bartering with other hospitals/wholesalers/distributors for medication. Some companies just decided to shut down production of a drug (glucagon) or another company filing bankruptcy (fuck you akorn). The nebulizer situation got so bad we had to sit down with providers to tell them how dire this actually was and you can’t just order albuterol for a cough when a kid in respiratory distress needs it more. And now we have to tell providers that they’re restricted in chemo and squeezing every ounce of drug so we don’t waste. It’s hell, and I hate it.

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u/Gray_Hound May 27 '23

fuck you akorn

What were they suppose to do ?

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u/VegasKL May 29 '23 edited May 29 '23

Not be managed so poorly? If a company can't turn a profit on the pharma/med-supply industry in the US, they're doing something wrong.

Edit Just looked them up, they had an annual revenue of almost a billion dollars and recently got busted by the DOJ for (basically) medicare fraud.

So it's safe to assume that they didn't run the cleanest ship and as such, probably overleveraged the hell out of the company. So, mismanagement.

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u/thieh May 27 '23

Everything which is listed as in shortage should have all its intellectual property permanently revoked so the generic makers can get to work immediately.

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u/cass314 May 27 '23

If the problem were IP, we wouldn't be short albuterol, antibiotics, and literally saline.
Here's the actual list.

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u/LynWolfe May 27 '23

Wtf? I didn't know inhalers were in shortage

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u/VaBookworm May 27 '23

Inhalers are not. Vials of albuterol for nebulizers are.

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u/beholdkrakatow May 27 '23

My grandma died with several unopened boxes of albuterol and when I tried to return them her hospice company just asked me to dispose of them. I found someone to donate them to but how much medication like that just ends up thrown away. And then to hear there is a shortage is alarming.

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u/North_Atlantic_Pact May 27 '23

Re-donated medicine is a very tricky thing, as even if it's sealed (and people have resealers) you often have to store medicine in certain conditions. The liability is probably not worth the benefit for most places.

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u/FunDare7325 May 27 '23

I needed to fill an antibiotic ointment prescription the other day, and had to call around to multiple pharmacies. People are getting sick at an alarming rate, this isn't just a shortage or IP issue.

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u/FALCUNPAWNCH May 27 '23

Emergency inhalers should really come with less doses to mitigate the shortages. Mine always expire with more than half of the doses left.

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u/maxcorrice May 27 '23

They’re usually good a good while after expiration, just not as potent

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u/sector3011 May 27 '23

Won't help. The problem is the drugs are unprofitable.

“Unfortunately, the profitability of this industry is very low or nonexistent,” Califf said. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology. That’s the core underlying reason for the shortage that we’re seeing.”

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u/farmtownsuit May 27 '23

It's long past time Congress creates a USPS like organization but instead of delivering mail they manufacture generic drugs. We shouldn't be worried about whether it's profitable to make important life saving medication

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u/Excellent-Shock2434 May 27 '23

IIRC California is going to start doing that with insulin.

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u/QueenJillybean May 27 '23

California doing it with a lot of drugs. Gavin creating hella jobs tbh to start making a lot of generic drugs cheaper. Just him signing the bill last year cut my adderall prescription costs down from $70 a bottle to $24 a bottle

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u/Scoutster13 May 27 '23

It's so awesome. I love that Newsome is doing this. It will surely help a lot of people.

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u/[deleted] May 27 '23

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u/standard_candles May 27 '23

Yep. I hope other states follow suit.

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u/RizzMustbolt May 27 '23

Given Missouri's track record with the meth that they make, that would be a bad idea.

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u/QueenJillybean May 27 '23

Yuuuup. Gavin is not fucking around with shit

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u/jmcunx May 27 '23

It may be better if other States join/pay Calif for this. I can see the "blue" states getting in on this with Calif. Red States, if true to their word, no because "socialism".

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u/snertwith2ls May 27 '23

Their constituents would rather die than do anything remotely "socialist" anyway.

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u/Unsd May 27 '23

Not true. They love "socialism" if it benefits them. It's just that they will simultaneously eat up right wing propaganda by the shovelfuls to vote against their own interests.

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u/singeblanc May 27 '23

One of the saddest videos I ever saw was a town hall meeting in some bumfuck nowhere red state, with everyone cheering as they voted to get rid of "Obamacare", and then afterwards someone said "Ok, you cured for it, no more Affordable Care Act", and then they were all "What?! No!! I love the ACA!! I need it to survive. Hate Obamacare!"

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u/wolfgang784 May 27 '23

At least for Insulin so far

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u/PrettyMuchRonSwanson May 27 '23

Damn, I wish I could get my Adderall prescription filled. This shortage is kicking my ass.

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u/kurisu7885 May 27 '23

Damn, that's quite a cut. Hopefully it starts an undercutting war.

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u/TechnicianPlenty May 27 '23

I know this is an oversimplification, and I, someone not in the field at all, couldn't even begin to predict the complexities of how this would shake out even if you had bipartisan support.

But, God, can you imagine, if the US government was actually representative and gave a shit. "Hey, we have a problem, how can we fix it?" Instead of "hey, we have a problem, what minority can we rile people up about so they don't ask about the problem?".

God I'm so tired.

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u/bellaphile May 27 '23

Oh “Hey we have a problem, who can we get to pay us so we pretend there is no problem?”

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u/LaLucertola May 27 '23

I'm in healthcare econ, it is an oversimplification and it is incredibly complex. I'm very cautiously optimistic about the California proposal, because even in a world without all the common criticisms of the pharma industry, there's a lot the plan needs to overcome.

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u/scarsinsideme May 27 '23

It would be utopian

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u/uptownjuggler May 27 '23

I know plenty of people that would love a government job working in a lab.

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u/Crazyblazy395 May 27 '23

The problem is that the government won't pay what pharma labs pay.

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u/HealthyInPublic May 27 '23

We really need better funding for public service jobs. I’m not in a lab, but I’m in public health and could more than double, nearly triple, my gov salary if I switched to a private pharma company. I turned down the offers for other reasons… but damn that salary would be nice.

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u/flannelback May 27 '23

Three quarters of the country want affordable healthcare, but the dozen or so CEOs of medical corporations don't. And that's the real issue. As long as they can keep the culture war active, most folks won't notice.

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u/Brooklynxman May 27 '23

Gee, if only there were some kind of collective we could all contribute to, some governing body that could subsidize these essential but unprofitable things, or perhaps even just take over production itself. I wonder what we'd call that.

Oh well, I guess if cancer patients can't make their treatment profitable they get what they get.

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u/HansVonpepe54 May 27 '23

In the Jurassic Park book Hammond talks about how he would “never help humanity” because it’s unprofitable.

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u/MightyMF May 27 '23

I'm in serious doubt that someone isn't making money off these drugs.

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u/SameFrequency May 27 '23

Unfortunately it is probably about relative profit. They aren’t as profitable as something else the company could produce. There are only so many facilities that can produce at pharma scale and with pharma quality standards.

If we had a socialized production program for these lower margin (but very important) drugs. It certainly would not lose money to your point.

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u/BearsuitTTV May 27 '23

It's exactly why there are shortages. Those drugs aren't worth it to manufacturers.

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u/thieh May 27 '23

Well, they passed a law not to negotiate prices, so there is no such excuse as to low profitability if they can just raise prices.

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u/wolfofremus May 27 '23

The cost of manufacturing those drug is really high, there is no point of rising the price if no one can afford it.

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u/MightyMF May 27 '23

I would need to see the details on why that is so to believe it. The pharmaceutical industry and to a certain extent the Healthcare industry, has low credibility with me on pricing and cost of care.

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u/thieh May 27 '23

We have no way to independently verify that claim unless other manufacturer start trying different ways to make said drug because currently only the IP holder can make them.

All forms of intellectual property kills innovation when you drag it out for too long.

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u/beaucoupBothans May 27 '23

This is going to happen more and more as profit increasingly takes precedent over need in medicine exasperated by the fact that few see government as the necessary manufacturer of last resort. Being convinced that government is incompetent and useless is self fulfilling self destruction.

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u/CaffeineAndInk May 27 '23

The problem is the drugs are unprofitable healthcare industry is profit driven.

FTFY.

I don't think your statement is inaccurate, but it seems like this is a good example of just how much worse things can get. Now, even if you have insurance, you might still be out of luck, because the pharma company that owns the rights to the drug you need can't gouge you on the price enough to keep their shareholders happy.

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u/cranp May 27 '23

These ARE generics. The issue is the razor-thin profit margins on generics.

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u/MydogisaToelicker May 27 '23

That is not the problem.

The top item on the list is saline solution.

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

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u/possiblycrazy79 May 27 '23

Yes my son is a part of the trach/vent population & our community has been dealing with these shortages for months. Saline, sodium chloride solutions, albuterol, sterile inhalation water and then there is a silicone shortage so many trach tubes are on back order for months. 2 years ago there was a circuit(ventilator tubing) shortage & then Philips respironics issued a recall on their ventilators & cpaps, which is still not fully resolved.

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u/shadeandshine May 27 '23

Dude setting up manufacturing for a drug isn’t something instantly prepared it takes months if not years to set up for a temporary problem. Also that wouldn’t do shit if the issue is a based on supplies needed to make it being short on hand or suffering a shortage.

You are praising it as some magic solution when it literally solves nothing. All it does is strip IPs. American medical care costs too much but you’re presenting a oversimplified solution that literally does nothing for the issue ,but confirm Reddits ideological biases. Even then generics have their own issues and heck you could’ve pointed to the FDAs approval process for cancer treatment drugs needs to be looked at cause we need new options.

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u/user_dan May 27 '23

For over a decade, I have been hearing calls for building out drug manufacturing infrastructure in the US and in third world countries. It would address shortages and the ability to deliver life saving treatments to poorer areas of the world.

The number one excuse by detractors is that the manufacturing process is complicated and building it would take "too long" (6-24 month time frame). Again, I have heard this same excuse for over a decade.

There is no better time than now to start expanding drug manufacturing.

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u/MyOldNameSucked May 27 '23

Quality standards in pharma are also extremely high. The pharma company I used to work for lost many customers to cheaper competitors in Asia only for those customers to come back 2 years later because the quality wasn't up to spec. We also had a daughter company in India that produced intermediaries for us. The quality of te final product was always lower if we used intermediaries produced in India compared to when we used the ones we made ourselves.

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u/matastas May 27 '23

Yeah, if you want massive lawsuits everywhere, that’s a great idea.

Drug shortages happen for a lot of reasons (in this case, profitability driving firms out of business), with quality issues being a big one. Generic manufacturers couldn’t spin up fast enough to plug the gap, and they might run into the same problems if a key excipient has been compromised or a process is tough to keep in compliance.

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u/upvoter222 May 27 '23

I assume I'm not the only person here who's never seen that word before:

Excipient = A substance in a medication other than the active ingredient

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u/matastas May 27 '23

My bad. Thanks for posting this. :)

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u/1sagas1 May 27 '23

I love when reddit tries to interject and solve a problem they understand nothing about.

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u/MyOldNameSucked May 27 '23 edited May 27 '23

Sometimes shit happens and batches can't be used. I used to work in a pharma producer and all of the sudden we had black specs in our product. The black specs turned out to be graphite, but we just couldn't find the source. Even though graphite is perfectly safe to ingest we could not sell those batches because safety regulations are very strict and most people wouldn't take a pill that is supposed to be white, but is full of black specs. In the end we just opted to use different equipment because our customer was running out of stock.

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u/Hobbit_Feet45 May 27 '23

Well fuck. Great time to find out I have cancer..

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u/Uniquitous May 28 '23

I guess there's no good time for that, but now is definitely a bad time for it.

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u/ApatheticWithoutTheA May 27 '23

I sure as fuck hope it’s handled better than the Adderall shortage I’ve been dealing with for the past year.

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u/[deleted] May 27 '23

That shortage is intentional. The DEA sets how much ADHD medication can be administered. Some bs about the DEA believes over prescription, thus the charges.

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u/ApatheticWithoutTheA May 27 '23

Yeah I know. It’s a mess even without that though. There’s no requirement for manufacturers to report basically anything about their status, a few of them have never even hit their APQ limit for the year so why they weren’t manufacturing more is still a mystery, Teva has had no issues keeping their brand name Adderall in stock but their generic has magically been in shortage for a year, quality control on some of the other generics is absolutely miserable.

Whole thing is insane. And our overzealous DEA and their bullshit certainly aren’t going to fix it.

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u/T1mac May 27 '23

What the fuck? These terrible written articles.

We have to scroll down to the very bottom of the article to find out who's to blame.

Big Pharma can't make enough profit curing cancer, so they outsource the manufacture of the medication to a sketchy contaminated factory in India.

It's time for Biden to invoke the Defense Production Act because this is a national emergency.

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u/BradleyUffner May 27 '23

We have to scroll down to the very bottom of the article to find out who's to blame.

You mean to say you have to scroll through all the advertisements to get to the good stuff? Sounds like it's working as intended.

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u/hibbert0604 May 27 '23

Why is every single aspect of modern day life getting worse? This shit is so fucking depressing.

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u/Judgementpumpkin May 27 '23

Are other nations reporting shortages? Or is this just another greed based excuse?

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u/DeezNeezuts May 27 '23

It’s api shortage as well as a bunch of Indian manufacturers keep screwing things up and failing inspections.

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u/user_dan May 27 '23

You can blame individual sites all you want, but the big pharma companies are running the show. If there is a problem in their supply chain, it is the big pharma company is responsible.

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u/toxic_badgers May 27 '23

I used to work it and it was largely supply chain vs demand as recent as 2 years ago. For several key drug components. There are only one or two places globally that make the components and everyone buys from them. So they didnt have enough for everyone. For some things like blood tubes it was labor and supplys. The resin to make the tubes was globally short and they didnt have the staff for all of their product lines to run 24/7 so they had to pick their highest demand items while waiting on resin... they couldnt hire more people because theyd burn through resin faster than they got it in. Its a complex problem and greed is only an answer to part of it.

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u/existentialelevator May 27 '23

Eh that isn’t always the case. It depends but sometimes you can only control your suppliers so much. Every control can be in place, yet they still fail. It happens quite often. Not everything is vertically integrated.

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u/ford_chicago May 27 '23

True, but they allowed/designed their supply chain to become this brittle and fragile because it is more profitable in the short term.

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u/TrashyTrashPeople May 27 '23

I've been impacted with the adhd med shortage recently. From what I learned, we import the ingredients to make the meds, so it may be a similar situation.

Also probably similar to what we experienced with supply chain/manufacturing problems and delays during covid, and increase in demand. This is what happens when things are run unrealistically, trying to pinch every penny for the people at the top to get their bonuses.

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u/LaLaLaLeea May 27 '23

Same. Every time my prescription is refilled, I have to call like 18 different pharmacies to find one that actually has it.

Trying to find a psychiatrist was frustrating enough. Eventually I just gave up and paid out of pocket to use one of those websites (none of them accept insurance).

This whole situation is so bizarre to me. The apocalypse is over but the world is out of medicine.

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u/Alternate_Ending1984 May 27 '23 edited May 27 '23

I did research into the ADHD med shortage because I had to call every pharmacy in the area to hopefully find one that had my meds in stock every month, and I was constantly dumbfounded as to why it was so hard to get.

Believe it or not, the DEA controls how much of the active ingredient the pharma companies can get EACH YEAR. Once they have received their yearly alotment they are cut off. Even though perscriptions for ADHD meds are up over 40% year-over-year the DEA hasn't made any substantial increases to the alotment of the active ingredients any pharma company will get.

Its a manufactured problem by the morons in charge.

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u/nedonedonedo May 27 '23

they actually cut the amount in 2022

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u/AuxiliaryFitness May 28 '23

I used to think this too, but it turns out the companies weren’t making their maximum allotment of the medication, so the DEA was basically like “Why should we let you make more of something you aren’t making enough of as-is?”

You can see the reasons for the shortages on the FDA website: https://www.accessdata.fda.gov/scripts/drugshortages/dsp_ActiveIngredientDetails.cfm?AI=Amphetamine%20Aspartate;%20Amphetamine%20Sulfate;%20Dextroamphetamine%20Saccharate;%20Dextroamphetamine%20Sulfate%20Tablets&st=c

It actually looks like things are improving from when I checked several months ago, many manufacturers listed supply or labor shortage as the reasoning

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u/HealthyInPublic May 27 '23

I’ve been dying at the absolute irony of forcing people with ADHD (who may be unmedicated due to the shortage) to call multiple pharmacies to search for their meds. It’s exhausting.

I had to set myself up an excel spreadsheet like a complete goober with about 20 pharmacies in my area that I have to call every month now. I can’t keep track of it all otherwise.

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u/ChickenBootty May 27 '23

Yes. I’m originally from Mexico and I remember posts from my cousin who is a doctor saying “Nos están matando” (They’re killing us) back in 2020-2021 bc clinics and hospitals didn’t have chemotherapy and other cancer fighting meds at all.

At the time I was going through my own cancer battle so it really stuck with me, I felt both lucky and guilty for being able to get treatment when hundreds and thousands of people back in my country could not.

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u/flannelback May 27 '23

Bringing the manufacturers back into our country would be a great first step. Not allowing for-profit healthcare to dictate our policies would be a great second.

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u/psychotronic_mess May 27 '23

The “Free Market” would like you to work non-stop for 40+ years, make a few replacements for yourself in that time, and then promptly die of cancer. It also wants you to do all of that quietly, with less bitching.

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u/ChickenBootty May 27 '23

When I was going through cancer treatments back in 2020 I remember reading how back in my home country of Mexico hospitals and clinics didn’t have chemo and other cancer fighting meds at all. It made me feel lucky and guilty for being able to get treatment when others could not.

Getting a cancer diagnosis is terrifying as it is and I can’t imagine being told that they can’t help you if that when time matters, your next treatment won’t happen for months. It’s a nightmare.

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u/Apprehensive_Gene531 May 27 '23

Ugh my dad’s cancer drug is still on shortage 😞 and it says my antidepressant is discontinued? Like wtf what am I to do when I run out?

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u/Commandmanda May 27 '23

Unfortunately, the profitability of this industry is very low or nonexistent,”

The major manufacturer/supplier is in India.

Carboplatin, cis-diamino-(1,1-cyclobutandicarboxylate)platinum(II), is made from cisplatin by reacting it with a solution of silver nitrate, and then with cyclobutan-1,1-dicarboxylic acid to form the desired carboplatin (30.2.5.2) [78,79].

So ..what? Cisplatin is a type of inorganic platinum that is manufactured, not mined.

So why is it unprofitable? The silver nitrate used in manufacturing it?

Silver nitrate is the least expensive salt of silver; it offers several other advantages as well. It is non-hygroscopic, in contrast to silver fluoroborate and silver perchlorate. In addition, it is relatively stable to light, and it dissolves in numerous solvents, including water. (wiki)

Or is it that India keeps experiencing COVID spikes, reducing the workforce?

Finally...you can buy it without insurance at $230, or $14.50 with.

I'm guessing that it's the insurance companies/Medicare/Medicaid that have negotiated a price that is too low for the manufacturer to make any money off it.

That's why the FDA and government has to step in, probably to offer supplemental payments.

just an educated guess

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u/halp-im-lost May 27 '23

In a sense, Medicare IS the federal government in regards to drug reimbursement. They also notoriously have the worst reimbursement rates which is why many private practices will only take a certain amount of Medicare patients.

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u/CriscoCrispy May 27 '23

I cannot give you enough upvotes. I am retired from health care. Medicare reimbursements often don’t cover the full cost of a medication, or other care for that matter. Insurance companies lower their reimbursement rates to match Medicare rates. It’s a mess, and the ones who are making money are the insurance companies. While I’d love to see some form of socialization in our health care system, if the federal government continues to insufficiently reimburse for medications and providers we won’t have enough of either.

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u/Locke_and_Lloyd May 27 '23

You also need to really not fuck up the synthetic process. A deviation or contamination makes the batch unusable. All it takes is one unqualified nephew of a government official hired as a favor to not wear gloves.

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u/bigavz May 27 '23

I was with you until your conclusion, as until the recent inflation reduction act, Medicare wasn't allowed to negotiate drug prices by Congress (and still doesn't). In fact, chemotherapy drugs are the largest class of prescription drug expenditure in Medicare. However it is still likely that pharmaceutical companies don't feel these drugs are profitable enough to provide a steady supply for consumers - I mean patients.

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u/dontworryimstupid May 28 '23

Two of the drugs that saved my life (for now) are in shortage as well as the pill form of the anti nausea med I took. The injection form knocks people the fuck out so a quick stop by chemo before work doesn’t work.

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u/SnooRadishes5305 May 27 '23

Scary stuff!

I was already stressed about the adderall shortage for adhd - for a disability that causes executive disfunction and makes time management extremely difficult the additional uncertainty makes managing medicine into an olympic sport

But the idea of not having these cancer treatments available at need - that is devastating

I will definitely be calling my state rep to get this issue on the table - it’s awful to be affecting survival like this

My heart goes out to cancer patients and their families and their doctors

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u/ucantharmagoodwoman May 27 '23

“Unfortunately, the profitability of this industry is very low or nonexistent,” Califf said. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology. That’s the core underlying reason for the shortage that we’re seeing.”

So, we can subsidize audacious, feckless bankers, oil barons who are destroying the planet, and corporate farmers who grow nothing because it's more profitable, but we can't subsidize makers of the most widely-used cancer medication on the planet?

How is this real life

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u/John082603 May 27 '23

Well said.

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u/zenverak May 27 '23

So first it was ADHD med shortage now this huh?

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u/Snoo-13480 May 27 '23

“Unfortunately, the profitability of this industry is very low or nonexistent,” Califf said. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology. That’s the core underlying reason for the shortage that we’re seeing.”

-it’s seems to me if there’s no economic incentive for drug producers maybe that government should subsidize their production. Oh wait we’re defaulting on our debt probably nevermind.

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u/Dead_Ass_Head_Ass May 27 '23

We're still many years away from having other non-chemo cancer treatments being commercially available to the public, but those treatments give me hope that chemo won't be needed soon.

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u/username_verified May 27 '23

Failure of capitalism

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u/Littlebiggran May 27 '23

The new game our twovtwo larger health providers do:

They won't give you a prescription refill unless you have a doctor.

They have abused the doctors and buried them in cover your company ass paperwork that many are quitting. This is despite the "no compete" clauses they signed. This literally takes them off the local market for two years. I lost two excellent doctors this way.

When your doctor quits, you do not automatically get a new doctor. You have to call to ask for a new doctor. I was told there was only one doctor -- the least popular one among patients. And the wait for her was 3 months.

Two of my doctors have quit in a row. One took early retirement. My appointment for the next doctor is in two months. I've already run out of two serious expensive medications and one affordable. They simply refuse to trust me with a refill.

Until the new doctor meets me, gives me another physical, and decides whether or not to be a dick about my medications, I'min trouble.

One of these large corporations begins with a G and ends with "uthrie". The other is a regional one.

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u/telim May 28 '23

The vast majority of the time if carboplatin is "first line" it's because there's no endocrine, targetted or immuno therapy available for your particular disease. It's used as a palliative-intent treatment for many metastatic / stage 4 cancers to buy people a little more time and hopefully a higher quality of life (I.e. With less pain). However, many elderly people cannot tolerate it and instead have a higher symptom burden and potentially even a shorter life span with it, but feel that they "have to try something!". Physicians need to get more comfortable discussing terminal diseases, talking about the dying process, and doing earlier referrals to palliative care teams.

Bottom line for me is - most cancer drugs for solid tumours (I.e. Not leukemia or lymphoma) are not curative intent and the lay public does not understand that. This article perpetuates that myth.

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u/Scruffyy90 May 28 '23

How did we end up with another major shortage of medicine?

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u/Enlightened-Beaver May 27 '23

Time to nationalize drug manufacturing

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u/digiorno May 27 '23 edited May 27 '23

Yes, making medicine a for profit venture was always a great idea. Love whomever decided just in time inventory management and care was a good plan for medicine. They truly earned whatever massive raise they surely were given. Nothing like artificial scarcity to drive up the price. Hooray for the shareholders! Quarterly profits are the only thing anyone should ever care about. /s

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u/WebbityWebbs May 27 '23

Once again, for profit health care is clearly a terrible idea.

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u/Earth_Normal May 27 '23

We need public health care ASAP. We should not have problems of profitability with life saving drugs.

CLEARLY we have a demand and it’s not being fulfilled at any price. It stinks of price fixing and anti competitive policies and practices.

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u/brooklynlad May 27 '23

Why can't we bring back drug manufacturing back to the United States where oversight is better?

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u/ClammyHandedFreak May 27 '23

I think this is a sad glimpse into the future.

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u/Tarzan_OIC May 27 '23

On the flip side, there doesn't seem to be a shortage of microplastics and chemical spills

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u/mrgameandwatch34 May 27 '23

Question: What changed? These drugs were in fine supply before the pandemic. It's been some time since pandemic restrictions were in place in most countries(save China). Is it Chinese suppliers having a hard time bringing production back up? Is it something else? Does anyone have any ideas about what could possibly be going on?

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u/anormalgeek May 27 '23

Why aren't all road systems privatized? Because it'd be a silly and impractical idea. Even if you don't like the idea of "big government" it's hard to argue that some things aren't going to make way more sense being handled centrally with zero profit motive.

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u/nubsauce87 May 27 '23

So they say that “intervention by congress” could help the situation…. Which is how I know the situation is completely fucked and will not get solved. At least not until the next congress, as this one is only interested in fucking around and wasting time investigating Hunter Biden’s laptop, because “owning the libs” is the most important thing in the history of ever.

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u/KALEl001 May 27 '23

why is there so much cancer that their is not enough meds. whatta world these christians made :P