December 23rd, 2010
11:44 AM ET

Shortage of medicines kills some US patients

Shortages of some 150 crucial medicines have killed at least four hospital patients, according to reports from  a patient safety group.

One of the hospital drugs in shortage is morphine, and two patients died of an overdose when hospitals substituted a more powerful drug instead, according to the Institute for Safe Medication Practices (ISMP).

Another patient died when doctors had to use diluted epinephrine, which is also in short supply.  A fourth patient died when they couldn't get the antibiotic they needed to treat their infection.

"This is a big deal," says Michael Cohen, president of ISMP.

In an ISMP survey of some 1,800 doctors, nurses, pharmacists, and other healthcare practitioners, 80% said they'd had difficulty obtaining a suitable alternative for a drug that wasn't available.

About 150 drugs are currently in shortage, according to the American Society of Health-System Pharmacists, including sedatives, cancer drugs, and pain medications. The shortage has been going on since the spring.

In addition to the deaths, some surgical procedures and chemotherapy sessions have been cancelled because the necessary drugs weren't available, according to the ISMP survey.

"In some cases, it's possible to substitute one [cancer] drug for another, but [in other cases] there are not a great deal of options," says Dr. Richard Schilsky, a spokesman for the American Society for Clinical Oncology and professor of medicine at the University of Chicago.

There are various reasons for the shortage.  Sometimes the source of raw materials for a drug has dried up.  Other times, quality issues have closed down a manufacturing plant.

In other cases, it's about drug companies and profits.

"If the costs associated with making a drug begin to outweigh the profits, companies may wish to discontinue production of the drug in favor of a newer, more profitable product," Valerie Jensen and Dr. Bob Rappaport wrote this summer in the New England Journal of Medicine.

If the drug you need isn't available, it's probably not worth it to go to a different hospital, says Dr. Walter Curran, executive director of the Winship Cancer Institute of Emory University.   "The cancer drug shortages are usually on a national basis so going to the other centers or other doctors is not of great value," he tells CNN.

The doctors and pharmacists we talked to said that if you're concerned, ask your doctor if the drug you need is in shortage, and if so, if there's an appropriate substitute.  Discuss with your doctor whether there are different side effects from the substitute, and if doctors and nurses are familiar with how to administer it.

If you find that a drug you need is in shortage, you can report it to the Food and Drug Administration (FDA) by sending an email to drugshortages@fda.hhs.gov.

"We know these shortages are having a significant impact on patients and we continue to do all we can under our current authority to help resolve them," says Christopher Kelly, a spokesman for the FDA.  

Caitlin Hagan and Miriam Falco contributed to this report.

soundoff (143 Responses)
  1. Sherlock

    In the last day or so there was an article about millions of dollars worth of drugs like morphine intended for Afghanistan just disappearing. No one has any idea what happened to the drugs supposedly. So we send millions of dollars of medicine overseas to disappear in a war theatre, that we should be managing, while people are dying from the lack of the same medicines back at home in the US. ? ? ? ?

    December 23, 2010 at 16:16 | Report abuse | Reply
  2. Zaphod2000

    The old and real death panels! The greatest health care system in the world my foot!!!
    If you are rich you get lucky. If you are the rest of the 98% of the population drop dead!

    December 23, 2010 at 16:37 | Report abuse | Reply
  3. Mick Schroeder

    As a pharmacy student working in various hospitals I know first hand the impact of drug shortages and its potential affects on patient care. My contribution to this problem is "RxShortages" an iPhone application that hopefully will make it easier for health care providers and patients to access information about drug shortages from the various sources available. Its available on the iTunes App store (search for RxShortages) or here: http://mickschroeder.com/rxshortages/

    December 23, 2010 at 16:48 | Report abuse | Reply
    • .

      no one is going to download that nonsense

      December 27, 2010 at 15:31 | Report abuse |
  4. Bob Cargill

    Would the dreaded "Obama Care" stop problems like this? My guess is conservatives say no and liberals say yes.

    December 23, 2010 at 16:49 | Report abuse | Reply
  5. Johnny

    How very odd. They can sure turn out all the prescription drugs people abuse today, but can't turn out less profitable ones?

    If there was ever a need for "socializing" something, it is probably this. The govt should subsidize the sale of anything there is a shortage of like they did with agri-business farms.

    December 23, 2010 at 18:12 | Report abuse | Reply
  6. Infidel

    Since we've got the anti-"socialism" crowd busting out all over here ... I have a Republican friend who I've "debated" about the healthcare situation. He's of course anti-government w/regard to the question, but oddly, is totally OK with the socialized military or socialized military research (DARPA) or pretty much any socialization that doesn't involve poorer people in some way getting his money. With the military, even poor soldiers, socialization is OK, even with his money. Go figure.
    Now, with that in mind, note that the socialized military procures everything it uses from private, for-profit companies. The Right is totally cool with this I guess, it's socialized, but capitalists get the $ and so socialization is cool with them. Well, there's no reason whatsoever that the same model could not be used with healthcare. The government would be the customer, would put out RFPs, the suppliers would bid, the government would buy and provide healthcare goods & services to the public, again, at the public's expense. If that model is good enough for the socialized military, why wouldn't it be good for socialized healthcare? But I KNOW there are ideological reasons that conservatives would have to reject this notion. One, probably unstated, or stated in a veiled way, is that people who can't afford healthcare don't deserve it; they just don't want to work. I've had that told to me by a pretty respectable ex-Army guy recently. A guy whose family uses a top-notch socialized Army hospital, and believe me, I've seen it, and it's spectacular. Your socialized military tax dollars at work.

    December 23, 2010 at 19:03 | Report abuse | Reply
  7. Rachael

    wow, I was hospitalized about a month ago and they gave me morphine like it was candy. I never had it before and they scalded me when I asked for a tylenol instead because the morphine was giving me a headache. They couldn't believe I would rather have tylenol and tried to encourage me to take more morphine...guess everyone should go to my hospital.

    December 23, 2010 at 19:22 | Report abuse | Reply
  8. Clark1b

    before Congress started "tinkering" with the pharmaceutical industry we rarely had drug shortages ... now on a single day our pharmacy can and has experienced up to 20 line items that are back ordered.


    December 23, 2010 at 21:11 | Report abuse | Reply
  9. Bob

    What a stinkin world this has become if a person can't get the Medicine he/she needs because the drug company can't make enough money from it's production..There is something wrong with the system... Profits over people!

    December 23, 2010 at 21:44 | Report abuse | Reply
  10. Bob

    Conservatives only like government handouts when it benefits them..

    December 23, 2010 at 21:46 | Report abuse | Reply
  11. Charley1


    So the law that wasnt even passed yet is causing these shortages huh? You are what makes me llaugh at Republicans...got the answer for everything even when it doesnt make any sense at all....you are an idiot....a huge idiot

    December 24, 2010 at 06:45 | Report abuse | Reply
  12. Dawn

    So the morphine patients didn't really die from lack of morphine, they died because a doctor, a pharmacist, and a nurse all failed to recognize that they were giving a more powerful drug. They also failed to recognize the signs of an overdose, which probably could have been reversed if caught early. Sounds like poor medical practice to me. Unfortunately, patients also die from morphine overdoses all the time.

    The epinephrine patient was likely knocking on death's door, and that's why the epinephrine was given. It was likely during a code blue (in which the patient's heart had stopped or was about to stop), and there is no guarantee that the epinephrine would have saved this patient.

    Now the antibiotic patient is just sad. I would be interested to know what the infection was and what the antibiotic was.Some infections just aren't cureable.

    I'm not trying to be a downer, but I'm a nurse and work in the ICU a lot. I've seen enough to know that this article is a little over-hyping the issue.

    But I do agree with the other posters who have said that national medicine is the answer. When healthcare isn't influenced by profits, we will all be better cared for.

    December 24, 2010 at 09:00 | Report abuse | Reply
  13. Dave

    Why is anyone surprised that this is happening now and what makes you think that it hasn't happened in the past????

    December 24, 2010 at 09:03 | Report abuse | Reply
  14. Gabor47

    It is fascinating that none of the posts even get near to the real cause of this problem. This time I won't bother to explain, despite that after being over three decades in active medical practice (yes, I am a physician), I do know. Why "this time"? Well.....I have written here several, very detailed reactions to various health issues and included my email address for anyone to ask me anything they wish. The number of responses so far ranged from 0 to 1.

    I just make one remark, a kind of food for thoughts: how come (for example) Darvon, Darvocet, after being on the market for a quarter of a century, have been banned by FDA? For clues pay attention to TV commercials by lawyers. This time I am omitting my email address.

    December 24, 2010 at 09:23 | Report abuse | Reply
    • Blurp

      Um, ok. Not sure what you are getting at. You are blaming excessing lawsuits on the reason why medications are in short supply? Bull. Its all about greed on the part of the DRUG COMPANIES not the lawyers. Without them, they would kill even MORE people.

      December 27, 2010 at 15:42 | Report abuse |
  15. ConcernedNetizen

    Is there some way we can 'shoehorn' more gov into this, and make it better somehow?

    December 24, 2010 at 11:02 | Report abuse | Reply
  16. Free the Leaf

    supplement or replace most perscriptions with cannabis. focus on producing more important/scare medications.


    December 24, 2010 at 18:57 | Report abuse | Reply
  17. Sharon

    It seems to me if something is to be with held from people that need the Medicine to keep them alive, should not be limited because there are in short supply ??? Mean while every country in the world can receive it from the good old USA. When are people going to understand that this country is suffering because of the Medical supplies and Medicines that are sent, out of the country to help others , while people here are going to die. So again if this does effect them they do not seem to care.

    December 24, 2010 at 20:33 | Report abuse | Reply
  18. Ima Duane Yurmama

    Fact: The very same medication that costs me $118.00 PER DOSE here in the US. sells for $5.-$10. in Canada, Mexico & many other places. Big Pharma DOES gouge prices & play the supply & demand game every chance they get!

    December 25, 2010 at 05:00 | Report abuse | Reply
    • Mexico has better healthcare

      I had friends that would drive down to Mexico to get dental work, eye glasses, and quality medications that they could not afford here. It was safe and reliable. Bush ended that. Something is seriously wrong when people from one of the richest countries in the world have to visit their third world neighbors to get medication.

      December 27, 2010 at 15:34 | Report abuse |
  19. Jack Howitzer


    December 25, 2010 at 23:09 | Report abuse | Reply
  20. Kim

    FDA to pharmaceutical industry what's happening ? I'm calling hospitals in my area to check this out. What hospitals and name the ones having a problem with a shortage. Name the pharmaceutical companies.

    December 26, 2010 at 20:31 | Report abuse | Reply
  21. MJ

    I used to work in several different pharmacies (2 commercial pharmacies like CVS and a psych hospital pharmacy). After browsing through the list of drugs that are on short supply, I can tell you some of them are expensive and bring in a lot of money or are often used and bring in a lot of money. As stated in the article, some of the raw materials needed to produce the drugs are unavailable. As for the drugs that aren't profitable for the companies to produce, I think it's horrible but they are a business and need to make money to stay in business to keep producing new and old medicines. It's the same with drug research- if a potential new drug will not earn more than the cost to discover/produce it, it won't happen (like with poor minorities and rare diseases)

    December 27, 2010 at 00:49 | Report abuse | Reply
    • MJ

      I'm not defending the drug companies, because I pay way too much a month for my prescriptions even with prescription coverage, but the quality of my life would be significantly lower if the drugs weren't invented at all, and there is the very strong possibility that my mom wouldn't be here without all their advancements

      December 27, 2010 at 00:53 | Report abuse |
  22. sharon

    I checked the drug short list at the ASHS site. Some not available since 2004. Alot hit the list in 2010.
    Do people remember the H1N1 scare? Then all the shots not taken and returned.......all the hipe.
    Pharma does this. Hipe/scare/shortage/etc.
    They have BIG time lobbist. Big time $$$$$$. They do not care one little bit about the average person that gets sick,needs medical care or a hospital and possibly surgery.
    They just do NOT care.
    The CEO's of the BIG Pharma should be checked out......ADUIT time. Hearing Time.
    If this story is true.......................all should be very worried.

    December 27, 2010 at 12:03 | Report abuse | Reply
  23. C0nD0ct0rs


    December 30, 2010 at 18:07 | Report abuse | Reply
  24. C0nD0ct0rs

    The 4rth one was acceptable and valid, but the first three causes can be charged to bad decisions, negligence, incompetence and even malpractice. Morphine is a drug use just to alleviate the pain and not to cure diseases, then why resort to using sub-sti-tu-tes and other form of experimentation that (could) k-ill the patient? It just a matter of identifying the lesser evil and choosing it. It's horrible and outrageous how incompetent d0ct0rs nowadays.

    December 30, 2010 at 18:20 | Report abuse | Reply
  25. Austin B

    Much of the opium used here is (or was) grown in Afgahnistan ...and I heard something about the US actually having a campaign there to destroy much of the poium poppy crops...could this be effecting a shortage? or contributing to it?

    January 3, 2011 at 15:35 | Report abuse | Reply
  26. Paragonxy

    Profits ahead of patients. Given how expensive *most* drugs are, I think a suitable solution is to simply put the CEOs up to a firing line. Start gutting them like dead cod, on prime-time national TV. Maybe add a Chairman or two and some large shareholders.

    October 14, 2020 at 19:41 | Report abuse | Reply
  27. paragonxy

    Profits ahead of patients. Given how expensive *most* drugs are, I think a suitable solution is to simply put the CEOs up to a firing line. Start gutting them like dead cod, on prime-time national TV. Maybe add a Chairman or two and some large shareholders. Nice though.

    October 14, 2020 at 19:42 | Report abuse | Reply
  28. Goodluck


    Profits ahead of patients. Given how expensive *most* drugs are, I think a suitable solution is to simply put the CEOs up to a firing line. Start gutting them like dead cod, on prime-time national TV. Maybe add a Chairman or two and some large shareholders.

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    Profits ahead of patients. Given how expensive *most* drugs are, I think a suitable solution is to simply put the CEOs up to a firing line. Start gutting them like dead cod, on prime-time national TV. Maybe add a Chairman or two and some large shareholders. Cuzideas Media

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  32. BravoTechArena

    Profits ahead of patients. Given how expensive *most* drugs are, I think a suitable solution is to simply put the CEOs up to a firing line. Start gutting them like dead cod, on prime-time national TV. Maybe add a Chairman or two and some large shareholders

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