But only a few generic-drug companies have the sterile facilities needed to make injectable drugs. The shortage of succinylcholine has complicated anesthesia that requires the use of breathing tubes. Supplies ran short in part because an alternative drug, Raplon, was withdrawn from the market in March by its manufacturer after it was linked to serious adverse reactions and the deaths of five patients. Abbott Laboratories, which also makes succinylcholine, has not yet made a decision on whether to increase production, spokeswoman Tareta Lewis said. So then you have to look at the resources and decide where you want to put them.
Economists say drug shortages reflect a complex set of circumstances.
In the drug industry, a wave of mergers and acquisitions has reduced the number of manufacturers, and those that have survived are focusing on the development and marketing of new products. The hospital market has become less attractive to drug makers than the outpatient drug market, which is much larger and more susceptible to advertising and promotions. As for the hospitals, which are also under severe financial pressure, they are bargaining hard for lower drug prices and are keeping inventories small. In some cases, hospital drugs have become scarce because drug makers can't obtain key ingredients from overseas suppliers. Princeton health-care economist Uwe Reinhardt is among those who support the notion of tighter government control.