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Drug Shortages, Errors and Increased Costs
Continued drug shortages are increasing the odds for medication errors and running up costs in hospitals. Last year there were over 240 drugs that were either in short supply or completely unavailable anywhere in the U.S., and shortages continue for many of the products. Purchasing alternate drugs or turning to different therapies due to shortages is costing providers at least $200 million a year.
A survey found that nearly 90 percent of respondents had experienced at least one drug shortage in the last half of 2010 that may have caused a safety issue that affected patient care.
There are a number of reasons for the shortfalls, including: a decline in the number of manufacturers from four or five for each product to two or one; production problems in plants; inadequate quality raw materials; and even an FDA initiative to require modern testing for long-used drugs that until recently had been presumed safe.
ISMP has identified at least 1,000 errors and adverse patient outcomes due to drug shortages. Errors included (1) A patient died from a bacterial infection that would only respond to a specific drug that was not available, (2) two patients died when they were given a pain relief IV drug at the dose set for morphine, when the drug they actually received was 6 times more potent, and (3) numerous instances were reported of patients getting too little anesthesia and waking up during procedures.
http://www.commercialappeal.com/news/2011/apr/20/drug-shortages-hit-hospitals-hard
Execution Drug Export to U.S. Banned by Britain
Britain is banning the export to the U.S. of three pharmaceutical drugs that are used to execute prisoners on death row. They are implementing an export ban for pentobarbital, pancuronium bromide, and potassium chloride that are used in lethal injections.
Their basis is "We oppose the death penalty in all circumstances and are clear that British drugs should not be used to carry out lethal injections." Also, "Because of the importance and urgency of the situation this is an issue on which we felt we had to take the lead."
This action follows a parliamentary inquiry that enough pharmaceutical drugs have been sold to the U.S. by licensed British wholesalers since last summer to execute 100 death row inmates.
http://www.guardian.co.uk/business/2011/apr/14/britain-bans-export-us-execution-drugs
Generics Rule!
Generic drugs now make up 78% of all prescriptions dispensed. And there are only three name-brand drugs on the list of the most commonly prescribed medications: Lipitor at #12, Plavix at #23, and Singulair at #25. It is interesting that all three are due to lose patent protection this year or next.
The top drug again was hydrocodone/acetaminophen with more than 131 million prescriptions dispensed last year, about 37 million more than the second-most popular drug, generic simvastatin.
Dollarwise, the top-selling drugs were Lipitor, Nexium, Plavix, Advair Diskus, and Abilify.
http://blogs.wsj.com/health/2011/04/19/what-drug-did-doctors-prescribe-most-last-year/?mod=WSJBlog&mod=WSJ_health
Lucentis vs Avastin Study to Be Released Soon
The results of a key study comparing Lucentis with low doses of Avastin will determine if Lucentis is better than Avastin; if not, Lucentis use may be decreased. The trial is sponsored by the U.S. National Eye Institute.
Billions of dollars of Lucentis sales hinge on the head-to-head comparison. If Avastin proves as good as Lucentis, it will offer an alternative for age-related eye disease at a fraction of the cost. Most analysts expect Avastin to prove as effective as Lucentis in the 1,200-patient test. Avastin is not indicated for ophthalmic use but it works in a similar way to Lucentis, and the tiny amount needed for an eye injection costs only around $50, against a U.S. price of $1,950 for Lucentis.
http://www.reuters.com/article/2011/04/20/novartis-roche-lucentis-idUSLDE73J1XO20110420
U.S. Drug Spending Slows: 2.3% Increase in 2010
U.S. spending growth on prescription drugs slowed to 2.3 percent in 2010-the second lowest level in 55 years and compares to a growth rate of 5.1% in 2009. However, even with the slowing growth rate, spending on prescription medicines reached $307.4 billion in the world's biggest market. The lowest U.S. spending growth rate ever reported was 1.8 percent in 2008.
http://www.lse.co.uk/FinanceNews.asp?ArticleCode=unw1uwcpsm6yu9z
&ArticleHeadline=US_drug_spending_slows_hits_307_bln_in_2010IMS
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