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Pharmaceutical shortages: Coming up short

FOSCARNET, potassium phosphate, kanamycin sulphate—for healthy people, these names are a meaningless garble. For the sick, the list is a nightmare. In 2004 America had a shortage of 58 drugs. Last year it had 211 and this year 198 so far. As the problem has spread, so too has a sense of panic, with patients lacking essential medicines, doctors fretting over alternatives and hospitals navigating a “grey market” for drugs. On September 26th the Food and Drug Administration (FDA) will hold a hearing with the hope of answering urgent questions: why the world’s biggest pharmaceutical market is failing its customers, and what might be done about it.The shortage affects a variety of treatments, but most are generic, injected drugs. Some can be replaced by other medicines, often inferior in quality and more expensive. Others have few substitutes. Hospitals are desperate, for example, to have electrolytes that keep premature babies alive, explains Erin Fox, who tracks drug shortages at the University of Utah. Oncologists are anxious for cytarabine, a leukaemia drug. “That’s the type of cancer that doesn’t have time to wait,” says Michael Link, president of the American Society of Clinical Oncology.The causes of the shortage remain tangled, but a few factors are probably to blame. First, manufacturing problems are increasingly common, as firms trim costs and import cheap ingredients…

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