Several doctors said they were using paralytic agents to keep COVID-19 patients from fighting the ventilator, as they deal with drug shortages that have forced them to improvise
FILE PHOTO: Co-director of the intensive care unit at CommonSpirit's Dignity Health California Hospital Medical Center, Dr. Zafia Anklesaria, 35, who is seven months pregnant, attends to a COVID-19 patient in the hospital where she works, during the coronavirus disease outbreak, in Los Angeles, California, U.S., May 18, 2020. REUTERS/Lucy Nicholson/File Photo
Underlying the persistent shortages - and the present crisis - are the basic economics of the American drug industry. The market discourages production of low-margin hospital injectable opioids in favor of high-profit prescription versions, according to interviews with dozens of government officials, medical practitioners and industry participants, as well as an analysis of government data.
Although ventilator use has fallen from the April peak, more than 7,000 COVID-19 patients are estimated to be relying on them each day. Several states are seeing a surge in cases, and many hospitals are resuming elective surgeries that were postponed early in the pandemic - further straining opioid supplies.
Production of pills and other prescription opioids used outside hospitals began to explode in the late 1990s as drugmakers pursued new patients, patents and profits. By 2006, production of outpatient prescription opioids was at least nine times that of the low-margin injectable opioids most widely used by hospitals, according to a Reuters analysis of U.S. Drug Enforcement Administration data. The findings were adjusted to account for differences in potency among the drugs.
Sen. Susan Collins, a Republican from Maine, said she had pushed for new incentives to encourage manufacturing of drugs at risk of shortage earlier this year, but federal agencies told her they did not want to pursue substantive action amid the pandemic. “This is a really important issue, and the coronavirus has really shined a light on it,” Collins told Reuters.
Patients can have hallucinations and become agitated on a second-line drug, said Dr. Mangala Narasimhan, regional director of critical care at Northwell Health, a 23-hospital system in New York. “You can tell they are really uncomfortable.”In Cleveland, the University Hospitals group has designated “SWAT teams” to move what supplies it has among its 18 facilities. And they are constantly shopping for more.
Johnson & Johnson’s Janssen Pharmaceuticals Inc began promoting fentanyl for this new market in 1997, decades after its invention. J&J’s patented, slow-release fentanyl skin patch, Duragesic, competed for blockbuster profits against another old opioid, oxycodone, which Purdue Pharma LP had re-launched in a patented slow-release pill called OxyContin.
Still, large hospital chains and purchasing groups have enough market power to drive hard bargains, the FDA-led drug task force found. Generic injectables are largely seen as interchangeable, so hospitals shop by price, not brand. For drugmakers, the report said, it’s “a race to the bottom.” He and other injectable manufacturers told Reuters they remained in the U.S. market because they believed it was the right thing to do. Hikma is still seeing sales growth, reporting that revenues from its injectables business rose 5% in the United States in 2019.When the novel coronavirus landed in the United States, the supply line for hospital opioids was still recovering from a setback three years earlier.
The shortfalls across the country underscored the vulnerability of the injectables supply chain. In a February 2018 letter to U.S. drug regulators, hospital administrators warned that surgeries might be postponed or canceled. “In some cases, this could prove life-threatening,” they said. “Sterile injectables are quite complex and costly to consistently manufacture,” Pfizer told Reuters. The company said it is now operating “without significant disruption” and has increased production of injectable opioids. It did not say by how much.The FDA requires manufacturers to update the agency on disruptions and shortages of necessary drugs. But those notices may be filed up to five days after a problem is identified - keeping the agency from taking action before a shortfall.
日本 最新ニュース, 日本 見出し
Similar News:他のニュース ソースから収集した、これに似たニュース記事を読むこともできます。
Norway Scientist Claims Report Proves Coronavirus Was Lab-MadeNorwegian scientist Birger Sørensen has claimed the novel coronavirus SARS-CoV-2 is not natural in origin. The claims by the co-author of the British-Norwegian study—published in the Quarterly Review of Biophysics—are supported by the former head of Britain’s MI6, Sir Richard Dearlove.
続きを読む »
Report: Biden To Meet With George Floyd’s FamilyThe family has previously spoken by phone with both Biden and President Trump, who they gave poor marks.
続きを読む »
National Guard Leaving Los Angeles Area As George Floyd Protests Continue In Peace – ReportThe California National Guard has begun the process of leaving the Los Angeles area after a week-long deployment, according to a report citing sources. The move comes even as protests continue thro…
続きを読む »
More universities report coronavirus cases in athletics programsSeveral universities joined a growing list of schools reporting coronavirus cases within their athletic programs. Last week, multiple reports surfaced that at least five players on the University of Alabama football team tested positive for the Covid-19.
続きを読む »