Drugs in short supply

You’ve seen it on TV, heard about it from friends and maybe (though we hope not) been clobbered by it yourself: the drug shortage.

You’ve seen it on TV, heard about it from friends and maybe (though we hope not) been clobbered by it yourself: the drug shortage.

The crisis has left cancer patients waiting for life-saving chemotherapy … parents scrambling for their kids’ ADHD drugs … doctors, nurses and hospitals in a tizzy … and frantic pharmacists saying, “Sorry, but we’re all out.”

The shortages tend to be at extremes. There’s a list of major cancer drugs at one end, including cisplatin (Platinol), doxorubicin (Doxil), paclitaxel (Taxol) and vincristine (Oncovin).

At the other end: everyday medications, including tetracycline, the antibiotic used for everything from acne to pneumonia; acyclovir, a standby for herpes and shingles; and leflunomide, a key rheumatoid arthritis drug.

In between are anesthetics for surgery and nutritional formulas for feeding tubes.

The AWOL drugs tend to have two things in common: They’re not pills; they’re injected medications, which can be harder to make.

And they’re largely not brand names; they’re affordable generics that have been around for years. That’s part of the problem.

Because profits on generics are low, their factories are often aging, breakdowns are increasing and quality control may have slipped as suppliers try to cut manufacturing costs. Worse, there’s almost no early warning system for drug shortages, and price-gouging is widely reported. Canada’s in the same boat.

Nobody’s got an inside track on dwindling supplies, as we YOU Docs have learned the hard way when friends and family have asked us to help them find medications. It ain’t easy. But these steps could help you survive a crisis:

1. Figure out a Plan B. Especially if you’re scheduled for chemotherapy, but anytime you’re starting a new prescription, ask your doc two questions:

l “Is there a chance this drug isn’t available or could disappear before I stop needing it?”

Sudden shortages are taking doctors, hospitals and pharmacies by surprise, so the answer may be, “I don’t know.”

Still, ask.

l “What do I do if the supply seems fine but suddenly dries up anyway?” Discussing your options now could prevent a cold panic later.

Possibilities include: choosing a backup drug; using another drug from the get-go; or, if possible, delaying treatment until the first choice is in sure supply.

2. Stay informed. Constantly updated lists of drug shortages are available online.

Check both the U.S. Food and Drug Administration (www.fda.gov/drugs) and the American Society of Health-System Pharmacists (www.ashp.org/shortages). Its list includes some meds the FDA’s doesn’t.

3. Don’t wait till the last second for a refill. Enough said.

4. Make like a Boy Scout. You shouldn’t have to do this, but until the shortages are resolved, be prepared: Program the phone numbers of all local drugstores into your cellphone, just in case. Don’t overlook the pharmacies inside your supermarket and big-box stores, or hospital outpatient pharmacies. Some are open to the public.

5. Don’t fall for a desperate solution. Shady Internet pharmacies that don’t require prescriptions and overseas drugstores with questionable standards are good routes to tainted or counterfeit drugs. Safe online pharmacies display a national seal of approval called VIPPS — for Verified Internet Pharmacy Practice Sites (www.vipps.info).

6. Taking Doxil for cancer? Register here. Janssen Products, maker of this drug, started its DOXIL C.A.R.E.S. program to get Doxil to those who need it most. Your doctor must fill out a form, which you also sign and send in. Get more info at www.doxil.com/doxil-supply-shortage.

7. Kick Congress in the pants. Prod it to pass long-stalled proposals requiring drug makers to warn the FDA six months before a potential shortage — or face million-dollar fines.

Also, ask your reps to back a plan to beef up FDA inspections of generic drug plants here and overseas (where 40 percent of drugs and 80 percent of active ingredients are now made). Money’s no excuse. The generic-drug industry itself has offered to put up $300 million for it. The American Childhood Cancer Organization and Ovarian Cancer National Alliance are urging members to push Congress for change. Push with them. We are.

The YOU Docs, Mehmet Oz, host of The Dr. Oz Show and Mike Roizen of Cleveland Clinic, are authors of YOU: Losing Weight. For more information go to www.RealAge.com