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Shortage in medications has some scrambling for alternatives

By Jed Boal | Posted - Feb. 17, 2011 at 7:25 p.m.

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SALT LAKE CITY — A shortage of mood stabilizing drugs has some parents in Utah, and nationwide, scrambling to fill important prescriptions for their kids and themselves.

Experts also said injectable drugs for cancer patients, which have few if any substitute medications, are also nearing short supply.

"A lot of people feel like it is a public health crisis,” said Erin Fox, manager of the University of Utah’s Drug Information Service. “Our drug supply is so fragile."

A lot of people feel like it is a public health crisis. Our drug supply is so fragile.

–Erin Fox

Clixie Larson learned of the drug shortages when she went to a pharmacy to fill prescriptions for her son and herself.

“I went to fill both of our prescriptions, he's on Adderall and I’m on Ritalin for ADHD, and the pharmacist said, ‘I'm not even sure we have it in.’"

She was told the FDA puts a production cap on those amphetamines and demand for the drugs hit that level.

In 16 years on Ritalin, Larson had never heard that. “They said good luck, call around to other pharmacies, and see if they have it in,” Larson said.

She was told it would be 6 to 8 weeks. Larson found her Ritalin at the third pharmacy she called, but not the Adderall. She may need to have her son's prescription rewritten for a different dose.

The U.’s Drug Information Service tracks drugs shortages nationwide. There were 210 drug shortages last year, up from 70 in 2006.

Potentially it's a crisis clinically for our patients if it comes to the point where we have to restrict treatment or change treatment because of these drug shortages.

–Dr. Thomas Miller

Last year was the year the service saw the highest number of shortages ever, according to Thomas Miller, chief medical officer at the University of Utah.

“Potentially it’s a crisis clinically for our patients if it comes to the point where we have to restrict treatment or change treatment because of these drug shortages,” Miller said.

He said the university so far has been able to get patients the medications they need.

One of the things that's unusual about this year, Fox said, is shortages of chemotherapy drugs and antibiotics.

“In both of those cases, there really aren't good alternatives to use instead,” Fox said. “For all these chemotherapy drugs you can't just substitute one out like LEGOS."

“Our critical shortages are in the area of the injectable medications,” Miller added. “And of those injectable medications they’re applicable to cancer patients. So that’s the group that’s going to be the most impacted by the shortage, should it hit.”

In addition to demand, raw material shortages and quality problems at the manufacturers can also limit supply.

"There are so few manufacturers of all these drugs that if even one company has even a tiny glitch then it resorts in a shortage," Fox said.

That's what happened with the Adderall, she said, and many other vital drugs in short supply.

Miller said the solution is to make sure that there are enough companies manufacturing these medications so that "we’d have a reasonable supply and backlog of needed pharmaceutical agents.”

Fox explained legislation pending in the U.S. Senate would require drug manufacturers to notify the FDA when drug supplies are running low. She said that type of transparency would get at the heart of the problem.

The U.'s Drug Information Service is looking into the Ritalin shortage, which appears to be localized.

It recommends that patients work with their pharmacists and doctors to assess availability of their drugs and look for alternatives.


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Jed Boal


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