Eye surgeons 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. Sometimes a company's ingredient supplier quits making a key ingredient, or demand temporarily spikes. Some manufacturers decide a product is not profitable enough. With increasing drug company mergers, there are fewer competitors making the same medicines anymore and thus fewer that can quickly pick up the slack.
Companies are notoriously tight-lipped in explaining shortages.
Shortages encourage price-gouging and sometimes doubling of prices, says Hopkins' Gill, who a day after the Wydase announcement got a call from a distributor with a stockpile looking to make a deal. Hospitals are feeling 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 critical 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 manufacture a larger competitor's castoff. But to help hospitals cope quickly, Utah's Tyler is working with the American Society of Health System Pharmacists to issue Internet bulletins warning of impending shortages and listing any alternatives. Tyler is warily watching whether a medicine crucial for heart surgery that's now on back order will turn into a real shortage.