What happens when drug shortages spike? You hope to get lucky, like me
Bad news, right-wing nutjobs – it turns out that getting sick is not just a problem for those freeloading, uninsured socialist troublemakers. With drug shortages on the rise – and other countries tightening the reins on treatment coverage – who lives and who doesn’t won’t be determined by politics but by the frightening economics of supply and demand.
A piece last month for the Wall Street Journal highlights the problem: Severe shortages of chemotherapy drugs, antibiotics and nutritional supplementation are leading to limited treatments and have caused “hundreds of clinical trials to be stopped.” Drug shortages have tripled in the last six years. And with a new high of 213 different drug shortages this year, patients with life-threatening conditions like high blood pressure, breast cancer, Kaposi’s sarcoma and leukemia have been affected.
Why the sudden shortfall? The WSJ cites both “industry consolidation and manufacturing problems,” but it’s more complicated — and insidious — than that. Because the profit margins on several of these drugs are small, companies have less incentive to keep making them. Harrowingly, the Associated Press reported last month that drug companies “don’t have to notify customers or the FDA that they’ve stopped making a medicine,” leaving doctors scrambling to ration drugs, delay treatments and scare up alternatives for their patients. At least 15 people have died in the past year as a direct result of drug shortages. Speaking to NPR last month, Assistant Secretary of Health and Human Services Howard Koh called the shortages nothing short of “a dire public health situation.” Want to know if your medication is an endangered species? Read the FDA’s current list and weep.
Meanwhile, the race for drugs with a profit potential has created its own set of life-or-death dilemmas. In the U.K. Friday, the National Institute for Health and Clinical Excellence cited “cost concerns” and what it deems “insufficient follow-up” when it announced it was not likely to recommend the newly approved drug Ipilimumab for the treatment of advanced melanoma. It was a move the British skin cancer awareness groups Factor 50 SKCIN swiftly condemned, saying, “The breakthrough that patients and clinicians throughout the UK have been waiting for has arrived in the form of this drug. Standard treatments that have been available since the 1970s are ineffective and to deny this drug to patients, many of whom are young and with very young families, has undoubtedly handed them down a death sentence.”
Ipilimumab, which was approved by the FDA just last March, is indeed a whoppingly expensive drug. In the U.S., a typical course of treatment is four infusions and runs $120,000. I know all about it, because I have metastatic melanoma, and because my immunologist happens to be one of the physician researchers who led the trials.
Last week, I began a Phase I clinical trial that will combine the Ipilimumab with a promising new drug, and for a longer course of therapy. I’d wager the Ipilimumab alone will run 200 grand. Fortunately, because I live in New York City, because Sloan-Kettering is my hospital, and because, on the cancer spectrum, I am considered both “young” and “healthy,” I get to be one of 64 people in America who can do this trial. Fortunately, because I’m in this trial, the drug company is picking up the tab for the treatment. Fortunately, because I not one of the nearly 50 million Americans without health insurance, my unrelated healthcare expenses – doctor visits, additional tests and lab work – are covered. In return, I am giving my tissue and time and enough blood to fill an elevator at the Overlook Hotel so that maybe someday soon someone else will get a lifesaving treatment. None of this, I know, will mean anything if it doesn’t work. But at least I have the chance to try this and still have time to try something else if I have to — an option that more and more of us with life-threatening conditions don’t have.
Survival isn’t just for those who, as Herman Cain puts it, can only “blame yourselves” for not being rich. And death and disease are not just for those who, like Ron Paul, think that’s “what freedom is all about — taking your own risks.” All the riches and “freedom” in the world won’t save your ass if you don’t have access to the right treatment. And when effective medicine isn’t getting out there because the financial incentive isn’t compelling enough, it’s just plain sickening.
More Related Stories
- Teen activist to meet with Abercrombie CEO
- Watch: Family emerges from storm shelter after tornado
- Okla. tornado survivor reunited with dog trapped in rubble live on camera
- My miscarriages made me question being pro-choice
- Why I tried to be a punk
- I'm terrified of the cicada onslaught
- Limbaugh: No one willing to impeach the first black president
- SAT's right answers are all wrong
- Supreme Court to rule on prayer at government meetings
- Father of gay high school student arrested for dating classmate speaks out
- Conservatives A-OK with closeted Boy Scouts
- Horrifying new trend: Posting rapes to Facebook
- Corporate greed is poisoning America -- literally
- The new geography of poverty
- Childhood ADHD linked to obesity in adulthood
- Obama to all-male university graduates: Be the best husband to "your boyfriend or partner"
- Chicago man breaks world record with 48-hour Ferris wheel ride
- I will never be able to afford Angelina Jolie's mastectomy
- GOP attorney general candidate tried to force women to report miscarriages to police
- Stephen Colbert to UVA: "You must always make the path for yourself"
- GOP actually bullies an anti-bullying bill
Featured Slide Shows
The week in 10 picsclose X
- 1 of 11
Lisa Montgomery embraces her nephew Thursday after a tornado tore apart her home in Cleburne, Texas. The twister killed six people and destroyed entire swaths of the North Texas town.
Credit: AP/LM Otero
Jack McMahon, the defense attorney for abortion doctor Kermit Gosnell, speaks outside the Criminal Justice Center in Philadelphia Tuesday. His client was convicted of killing three babies in his clinic, and will serve multiple life sentences.
Credit: AP/Matt Rourke
A photo taken Monday captures Vice President Joe Biden's response to a Milwaukee second-grader's innovative proposal to end America's epidemic of gun violence. This guy!
Credit: AP/Jenny Aicher
Sen. Rand Paul, R-Ky., flanked by a grouper-eyed Michele Bachmann, addresses the IRS' admission that it targeted Tea Party groups in advance of the 2012 election. In an op-ed for CNN Thursday, the Kentucky senator slammed the president for his faux outrage.
Credit: AP/Molly Riley
Ousted IRS chief Steven Miller is sworn in on Capitol Hill Friday. Miller testified before the House Ways and Means Committee on the extra scrutiny the agency gave conservative groups applying for tax-exempt status.
Credit: AP/J. Scott Applewhite
Attorney General Eric Holder pauses as he testifies on Capitol Hill before the House Judiciary Committee Wednesday. Holder is under fire, among other things, for the Justice Department's gathering of phone records at the Associated Press.
Credit: AP/Carolyn Kaster
O.J. Simpson sits during an evidentiary hearing at Clark County District Court in Las Vegas, Nev., Thursday. Simpson, who is currently serving a nine-to-33-year sentence in state prison for armed robbery and kidnapping, is using a writ of habeas corpus to seek a new trial.
Credit: AP/Las Vegas Review-Journal/Jeff Scheid
Major Tom to ground control: On Sunday astronaut Chris Hadfield recorded the first music video from space, a cover of David Bowie's "Space Oddity."
Credit: AP/NASA/Chris Hadfield
When it rains it pours. President Barack Obama speaks during a news conference Thursday with Turkish Prime Minister Recep Tayyip Erdogan, inexplicably inspiring an #umbrellagate Twitter meme.
Credit: AP/Jacquelyn Martin
A smoke plume rises high above a road block at the intersection of County A and Ross Road east of Solon Springs, Wis., Tuesday. No injuries were reported, but the the wildfire caused evacuations across northwestern Wisconsin.
Credit: AP/The Duluth News-Tribune/Clint Austin
Recent Slide Shows
- 1 of 11