Wydase

More medicine shortages feared

Hospitals often left with few good alternatives when supplies run out

By LAURAN NEERGAARD

Associated Press

Tuesday, February 20, 2001

Washington -- Hospitals nationwide are rationing adult tetanus shots, reserving them for burn victims and other severely injured patients because of a huge shortage of the crucial vaccine.

Shortages of medications that hospitals use every day are occurring more frequently, and they more often involve products with few good alternatives.

So far the tetanus crisis concerns only adult versions of tetanus vaccine, not children's vaccine. But experts with the Centers for Disease Control and Prevention are watching closely to see if the shortage spreads -- and worrying about adult illnesses this spring, when vaccine demand rises along with a seasonal jump in injuries.

In Wisconsin, health care workers are being asked to cut back on tetanus-diphtheria vaccinations. However, state officials say nobody who really needs a shot will be denied one, and hospitals in the Milwaukee area are reporting a sufficient supply.

Supplies already were tight nationwide because of production difficulties when Wyeth-Ayerst Laboratories last month stunned hospitals by suddenly ceasing to make the vaccine altogether, calling it a business decision.

CDC praises the sole remaining manufacturer, Aventis Pasteur, for working around the clock to brew more of the millions of doses needed annually. But each batch takes 11 months to make, so relief isn't expected before year's end.

It's not the only shortage. Abbott Laboratories has run out of lifesaving intravenous Isuprel, kept on hospital "crash carts" to revive cardiac arrest victims, because of a problem with its ingredient supplier. Doctors are using workable but somewhat less desirable alternatives.

Ophthalmologists are stretching final supplies of Wydase, important in numbing eyes for cataract and other surgeries after Wyeth abruptly quit making it, too.

Also in short supply is the powerful painkiller fentanyl, and Narcan, used to reverse morphine overdoses.

Nobody keeps good statistics, but the nation's largest hospitals and the Food and Drug Administration agree that shortages -- lasting from weeks to months at a time -- are increasing from a few crucial drugs a year to about a dozen, because a company's ingredient supplier quits making a key ingredient or demand temporarily spikes.

Sometimes the FDA discovers health-threatening violations in a factory and temporarily halts production, partly to blame for last fall's flu vaccine shortage.

Some manufacturers decide a product is not profitable enough. With increasing drug company mergers, fewer competitors are making the same medicines anymore, and thus fewer that can quickly pick up the slack.

Hospitals are experiencing shortages sooner than ever before because, faced with steep medication costs, most now keep only a few days' supply in inventory.

The FDA and CDC are studying which crucial drugs are most at risk for shortages, and FDA officials are trying to ease the situation by finding overseas ingredient suppliers or encouraging small drug companies to make a larger competitor's castoff.

OTHER SHORTAGES

Isuprel, kept on hospital "crash carts" to revive cardiac arrest victims.

Wydase, important in numbing eyes for cataract and other surgeries.

Fentanyl, powerful painkiller.

Narcan, used to reverse morphine overdoses.

Copyright 2001
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