First, the good news:
President Obama
will issue[has issued] an executive order on Monday that the administration hopes will help resolve a growing number of critical shortages of vital medicines used to treat life-threatening illnesses, among them several forms of cancer and bacterial infections.The order offers drug manufacturers and wholesalers both a helping hand and a gloved fist in efforts to prevent or resolve shortages that have worsened greatly in recent years, endangering thousands of lives.
It instructs the F.D.A. to do three things: broaden reporting of potential shortages of certain prescription drugs; speed reviews of applications to begin or alter production of these drugs; and provide more information to the Justice Department about possible instances of collusion or price gouging.
That would be the shortages of at least 180 drugs, with consequences that include at least 15 deaths over the last year and a bit, including these nine:
In the worst known case linked to the shortages, Alabama’s public health department this spring reported nine deaths and 10 patients harmed due to bacterial contamination of a hand-mixed batch of liquid nutrition given via feeding tubes because the sterile pre-mixed liquid wasn’t available.
The President’s response to this crisis is hardly perfect, as the administration admits:
The president’s order is a modest effort that, while possibly helpful, is unlikely to resolve the problem soon or entirely. Administration officials characterized it as one step in a long and complicated effort. Indeed, Mr. Obama eschewed more ambitious proposals — like government drug stockpiling or manufacturing — that would have injected the government more directly into the nation’s drug market and cost more but that might have been more effective.
Why might the administration have foregone such more potent responses to the crisis?
Guess:
Such efforts [as those in the executive order] are included in proposed legislation that has been pending in Congress since February despite bipartisan support for its provisions.
That is: we can’t even get through Congress a bill that requires only an improved warning system for drug shortages. Not even one with bipartisan sponsorhsip in both houses. Why not? Nothin’ personal — nothing to do with this legislation, cause all this is just business. By which I mean, given that the Republican leadership in Congress had decided that they will succeed if the President fails, (see also this chart on filibusters), even the most obvious and necessary of ideas can’t get through. More money to place the government in the drug business — notgonnahappen, and President Obama cares enough about actually improving policy outcomes sufficiently to grab what he can.
So let me go all Michael Moore on you here: on the evidence, your contemporary Republican party would rather Americans die for want of drugs and/or the distribution of dangerously improperly prepared pharmaceuticals than allow even the most modest positive move to be chalked up on Obama’s watch.
And, of course, when Obama demurs, it’s the jackboot coming down [warning: Fox News link] on the necks of the defenseless (sick) American people.
Oh — and the reason for the shortages? As summarized by the Times, report from the FDA and more information from HHS suggest the primary cause would be
…a dysfunctional marketplace for drug shortages, directly contradicting assertions by some commentators that government rules are to blame. The analyses found that 74 percent of the medicines in short supply in 2010 were sterile injectibles, the kind of drugs delivered in hospitals or clinics to treat cancer or anesthetize patients before surgery.
The economic and technical hurdles to participating in this market have made it exceedingly inflexible, the analyses found. Just five large hospital buying groups purchase nearly 90 percent of the needed medicines, and only seven companies manufacture the vast majority of supply. In most cases, one company produces at least 90 percent of a drug’s supply, and crucial ingredients — many of them made in mammoth plants in India and China — are often difficult to find, verify and approve, so years are needed to create new capacity. While demand has grown steadily in recent years, supply capacity has remained largely unchanged.With so much supply dependent on so few companies and facilities, safety problems that arise anywhere in the system can result in enormous disruptions. Nearly half of the shortages followed inspections that found serious quality problems, including injectibles that had glass shards, metal filings and bacterial and fungal contamination, the reports found.
How bad is it? Bad enough that the market players understand what’s at stake. The Times again:
Even the generic drug industry is calling for more regulation. The industry recently agreed to provide the F.D.A. with nearly $300 million annually to bolster inspections and speed drug applications. That amounts to about 1 percent of the industry’s revenues and about 5 percent of its profits in the United States, an extraordinary vote of confidence in the government’s ability to improve the situation.
So there you have it. Wingnuts want the market to be free to kill us. The drug companies want the government to do what most sane people thinks is its appropriate role: addressing market failures that threaten grievous harm.
And there, ladies and gentlemen, is the 2012 election in a nutshell.
Image: James Gillray, The Cow-Pock—or—the Wonderful Effects of the New Inoculation! the Publications of ye Anti-Vaccine Society, 1802.
TheStone
It’s becoming increasingly evident that the terminal illness that has afflicted the GOP for decades has now taken its final turn for the worse. The resultant fever dreams are becoming more detached from reality, or any efforts at coming to grips with said reality. The divorce between Republican thinking on this topic and that of the drug companies is quite telling. What you have here is GOP lawmakers catering to IMAGINARY LOBBYISTS who exist only in their heads. They don’t even need the suits in Gucci Gully anymore. Wind-up toys who keep marching in circles long after the keys in their back have stopped turning.
TheMightyTrowel
Love the artwork!
Baud
I don’t follow Michael Moore, but I’ve heard he’s been spending his time lately attacking Obama rather than the Republicans.
pamelabrown
What a sorry state of affairs. I hope we occupy the voting booth and get these wankers out of congress.
agrippa
I am glad that PBO has done that.
This issue does frame the 2012 election.
WereBear
This truly is like having a family member descend into full-blown paranoid schizophrenia, and your parents decide to lock them in the attic as a sensible solution.
TheStone
@WereBear: Which was the typical treatment of schizophrenic individuals during the period of history that the GOP sees as the model for tomorrow.
cinesimon
@Baud: Actually no he hasn’t been. At least, he’s been doing very, very little of that.
You could always, oh I don’t know, go to his website (michaelmmore.com) to see what his priorities are.
Rather than allow the bits that seep through from the media to inform you. They certainly want you to think that, but really if you believe it, you’re agreeing to be informed by Frank Luntz and clones.
SiubhanDuinne
@pamelabrown:
OCCUPY THE VOTING BOOTH would be a great 2012 slogan/bumper sticker for us!
Especially if one of the “O”s were the Obama logo.
Baud
@cinesimon: Chill. I fully admitted that I was hearing info about more second-hand. I’m not interested in following Moore.
pamelabrown
@SiubhanDuinne:
On Saturday, I’m going to “Occupy St. Augustine” and am making an “Occupy the Voting Booth” sign. Hope it catches on.
cinesimon
Thanks Baud! Yeah I’m really really upset. Totally. Thanks for reminding me I need to chill – boy did I need that!
So basically your post was one of those weird ways to pass the time – whilst telling people you like to post about people you have no interest in, and don’t really care whether your contribution bears any resemblance to the real world.
May I suggest you go join the tea or fire baggers – that’s their thing.
Baud
@cinesimon: I’m sorry. I don’t know where I got the idea that you needed to chill. I was way off base.
Chris
@pamelabrown:
You’re from St. Augustine? Shout out! (I’m not, but my grandmother lives there and I’ve spent many summers, Easters and Thanksgivings there since I was a wee little lad. Great place).
Admiral_Komack
Fuck Micheal Moore…and I’m chillin’
eemom
@Baud:
You heard right.
Fuck that asshole.
Angela
One of the drugs I am on to control my lupus has been involved in this chronic shortage. I often need to wait a month for my pharmacist to be able to find the medicine when I need a refill. These are usually meds that require a consistent long term level for best results. I haven’t had that for two years. I had no idea what the problem was, thanks for the info Tom. Occupy the Voting Booth indeed.
Sloegin
MBA’s fuck everything. It’s hard to be a Drugster these days, living on those slim profit margins making meds that keep people alive, trying to get your Chinese suppliers to not screw up the next batch of orders like they did the last… all the time you’re thinking, screw this, time to dump those products and enter the boner pill / statin / antacid lotteries to win the big score.
Angela
@WereBear: It seems to me more like the family gives them the ability to plan the budget, the meals, and pay the bills.
Roger Moore
I’m not sure you can call the failures in something like this a pure market problem; nothing in the business is a pure market interaction just because it’s so heavily regulated. It’s hard for manufacturers to get new suppliers because everything has to be carefully documented, there have to be QA/QC procedures for everything, and any deviation from the existing system needs to be justified. Try reading 21CFR211 sometime to get a flavor of what kinds of manufacturing restrictions the business is under.
That’s not to say I disagree with the degree of regulation. Most of the regulations are, if not quite common sense, at least a reasonable attempt to make sure drugs are exactly what they say they are and don’t contain anything that shouldn’t be there. That’s necessarily a painstaking process, and not one where you can expect new manufacturers to step in as quickly as they can in other businesses.
Baron Jrod of Keeblershire
@eemom: Michael Moore has done more good in his life than you ever will. Oh but who cares about that, because this one time he pointed out the blatantly obvious fact that young voters stayed home in 2010 because they soured on Obama. He’s not telling anyone not to vote for Democrats, he’s simply pointing out that they didn’t.
I guess in your world, being one of the loudest voices to speak unambiguously in favor of liberal policy and against right-wing lunacy during the dark days of the Bush regime doesn’t count for squat. Sure, he’s had to deal with constant death threats and mockery for his trouble, but yaaaawwwwwwnnn. Nope, the one and only thing that matters is whether he slobbers on Obama’s knob with enough tender loving care.
Fuck you, asshole.
(By the way, according to your link, Moore says he’s voting for Obama. What an asshole, amirite!)
@Baud: Thanks for jumping in with your uninformed opinion. I was sitting here thinking to myself, “How does Baud feel about Michael Moore based on some half-remembered rumors?” Well now we know, and are richer for it.
J. Michael Neal
@Baron Jrod of Keeblershire:
This would be a more persuasive argument if it were true. Did fewer young voters turn out in 2010 than in 2008? Yes. EXACTLY AS WOULD HAVE BEEN PREDICTED BY ANY STUDY OF OFF-YEAR ELECTIONS VS. PRESIDENTIAL ELECTIONS. Nothing unusual happened in the 2010 youth vote. They didn’t stay home because they were particularly disappointed in Obama. They didn’t stay home because they were particularly upset with Democrats.
They stayed home because that’s what voters do when there’s no presidential election on the ballot. What was unusual about 2010 was not youth turnout, or black turnout, or minority turnout or any other sort of turnout that tends to vote Democratic. What happened was that right-wing turnout was unusually high for a non-presidential election year. Any theory as to what happened that turns upon an unusual lack of motivation on the part of Democrats is a counterfactual. That’s just not occurred.
SixStringFanatic
Does anybody remember the subject matter of Michael Moore’s first film, the one that launched his Big Hollywood Career? It was about the economic devastation suffered by Flint, MI when General Motors removed its manufacturing operations from Flint.
Does anybody remember the auto industry bailout, wherein a newly-installed President Obama vigorously and repeatedly voiced his support for federal bailouts for GM, Chrysler and, by extension, the entire US auto industry in the face of vigorous and repeated opposition by the Republican Party and many of its “leading lights”?
And now Michael Moore will gladly appear in front of any TV camera you wish to point at him, so long as he is allowed to loudly and repeatedly proclaim his “disappointment” in the “ineffective” President Obama.
Those of us who are still from the midwest call this “Goin’ Hollywood.”
It also explains why many folks here, and I count myself among them, believe that Michael Moore can fuck right the fuck off.
Baron Jrod of Keeblershire
Again, Moore said he plans to vote for Obama.
What a dick! I mean, who says such things?
Now that Moore has said such a horrible thing he is beyond forgiveness, correct?
BTW, SixStringDouchebag, I’m from the midwest. You know what midwesterners call Michael Moore? A fat communist. Because most of my fellow midwesterners are fucking morons.
But I’m glad you have your eyes on the prize. Nothing, I mean nothing is more important than attacking your natural allies for insufficient vigor in their praise for Generalissimo Obama. The man who stops clapping for him first must be disappeared!
RalfW
I heard some Fox droning in the background at my dad’s on Monday, only caught the drug industry moran on the TeeVee saying that as drug profits have dropped, these shortages are to be expected.
Huh.
* “Pfizer 3Q Profit Surges…” WSJ 11/1/11
* “Roche on track – full year earnings outlook increased” roche.com news page 7/21/11
* GlaxoSmithKline sales up 6%, dividend raised 6% – gsk.com/investors
I could go on.
These companies are making billions, and while it’s nice that the generics industry wants a tad more regulation, the big boys are still pillaging for profit.
And with only 24 comments on this thread, I can see that even Juicers aren’t that into this rather important topic. Huh.
WereBear (itouch)
I sense the classic “not making enough money” excuse. So what if it saves lives? What does that have to do with profit?