The Philadelphia Inquirer
PHILADELPHIA, Pa. — Rationing medical care is denounced as immoral in the United States, yet it goes on daily in hospitals, clinics, nursing homes, ambulances, and pharmacies.
Since 2006, this country has had worsening shortages of sterile generic injectables — drugs given by shots or intravenously. Currently, more than 300 medicines crucial to treating cancer , infections, cardiac arrest, premature infants, pain, and more are in short supply.
The reasons for this predicament are complex, and the fixes, elusive. The scope, however, is clear from surveys of medical and trade groups. The latest, a University of Pennsylvania poll of oncologists released this month, found 83 percent had dealt with shortages by delayingcancer treatments , omitting doses, using second-choice drugs, or sending patients elsewhere.
"Oncologists are facing wrenching decisions about how to allocate lifesaving drugs," said cancer specialist Keerthi Gogineni, who led the Penn survey .
Why aren't patients and families up in arms?
They may not realize their care was compromised or complicated by a shortage unless their caregivers are unusually candid.
"Patients in an intensive care unit often don't know they've been impacted," said pharmacist Erin Fox, who tracks shortages as manager of the University of Utah's drug-information service. "And the hospitals don't want folks to talk about it. They don't want to admit, 'We had a patient who died because we didn't have this drug.' "
The secret human toll is rising. In the last three years, dozens of deaths due to contaminated drugs have been linked to producers and vendors who have capitalized on shortages. The Institute for Safe Medication Practices (ISMP) in Horsham received hundreds of reports of medication errors, near-disasters, and 15 deaths related to shortages when it surveyed 1,800 health-care practitioners in 2010.
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