The growing drug shortage

Now with cardiovascular drug shortage

I intended to write something else today, part covering recent news on the mRNA, and about (the failure) of mRNA among some of my own opinions (which I never share). But, a more concerning matter arose, and I decided to update my reader on the matter.

The long lasting drug shortage

While I stopped covering every new viral outbreak, I think most of my readers are aware using other sources of information of the multiple outbreaks of respiratory, bacterial, and other opportunistic infections going around, in both adults, but especially children.

At a local level, there are small outbreaks of entire schools getting the same infection, a friend from Chicago, her son's entire school is experiencing both strep and an influenza outbreak. RSV is ripping through untold amounts of kids, the list could go on so much I would literally get bored. The antibiotics situation has been deteriorating for a long while, and given the “sudden” rise in infections, no surprise there is a radical shortage of certain antibiotics going on.

Some antibiotic products containing amoxicillin in short supply, Health Canada says

Some products containing a commonly used antibiotic are in short supply, according to Health Canada.

The regulator told Global News on Friday that four companies — Sanis Health Inc., Apotex Inc., GlaxoSmithKline Inc. and Teva Canada Limited — are reporting shortages of drug products containing amoxicillin, an antibiotic commonly used for ear infections and sometimes pneumonia. There are still eight other companies that market amoxicillin products in Canada that are not reporting shortages at this time though, according to the agency’s Drug Product Database.

The Amoxicillin shortage: What you should know

Both are common childhood illnesses, for which the go-to prescription is in short supply, according to a recent nationwide alert from the U.S. Food and Drug Administration.

The warning specifically involves the powder, which pharmacists use to mix liquid Amoxicillin for childhood infections.

It was in stock Friday at Thomas Health in South Charleston.

That was not the case a week and a half ago. That’s when a pharmacy at the hospital was without it for two to three days, said Scott Brown, outpatient pharmacy director for Thomas Health.

Despite shortage there and elsewhere, Brown said there is no reason to panic. He offered this advice for parents who find themselves at a pharmacy with no Amoxicillin.

Ireland, and Australia are both experiencing among other drug shortages, also an amoxicillin shortage. The EU has a cardiovascular drug shortage “In late September, the EMA reported shortages of the two acute heart attack treatments alteplase and tenecteplase. According to the agency, shortages of both drugs are expected to last until 2024”. The NHS drug shortage grew 200%.

The drug supply chain is sometimes even more fragile than any other “just in time” supply chain, with many moving parts, and a certain level of non-linear dynamics ruling over the entire system.

All the agencies responsible for dealing with such matters are bound by the slow beast of bureaucracy, and are retroactive (something I have criticized since day 1 in my Substack, how retroactive people who are supposed to solve societal issues are). I do not expect this to get better in the short term regardless, and if we add the fact that disease is spiking everywhere, countries that export API (Active Pharmaceutical Ingredients) or drugs might halt exports for the safety of their own population.

Drug shortages aren't going away any time soon, supply chain expert warns

Last year, vials of the decades-old chemotherapy drug fludarabine could be purchased for a wholesale price of around $110. Not so much anymore.

This year, one company—Areva Pharmaceuticals—has jacked the figure up to $2,736, Stat News reports. 

What’s going on with the aging chemotherapy used to prepare patients for cancer treatment?

It all comes down to supply chain problems triggering shortages that affect the only other two suppliers of the drug in the United States—Teva and Fresenius Kabi.

This and other well-documented shortages aren’t going away any time soon, according to Bindiya Vakil, CEO of Resilinc, a California-based firm that helps companies from a variety of industries mitigate supply chain problems.

While shortages of high-profile drugs such as Adderall and amoxicillin have garnered headlines recently, Vakil points to a recent FDA warning that has the potential for more far-reaching consequences. 

The agency flagged shortages of more than a dozen drug ingredients, two of which are included in Adderall. Others include bacteriostatic saline, which is necessary for diluting drugs for IV injections, and compounds used in common drugs for anesthesia, water retention and calcium deficiencies.

“The drug industry is not really taking a proactive approach to understanding their supply chain dependencies. And they continue to be surprised time and time again,” Vakil said

By mere chance, I went looking for at least some information on the API state, and as one can clearly read above, the API situation isn’t improving, we now have active shortages of the ingredients to make important drugs. I must cover all the other dynamics in my Beyond Mathematical Odds series which will explain my next statement.

There is a very low likelihood of this situation improving, even if competence was soon to arise among the leadership of both drug companies and government, solely based on the global energy situation, the financial, logistical, and fuel problems most countries are experiencing, and all the trends that I have covered for the most part of the last 11 months, and they are still at play. Doesn’t help that factories keep facing problems too.

The advice in the substack linked at the start remains the same. If there are drugs you use or want to stock you should look into importing them and creating a small stock, you should definitely stock antibiotics. The import of most drugs is not prohibited, some of them might the confiscated but that is about it, even Modafinil is not actively banned, if caught you just lose the package.

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