If there is one thing you read today about #COVID19 today, it's this op-ed from @choo_ek &
@VincentRK one what federal government must do to prepare for the next battle: medicine shortages. nbcnews.com/think/amp/ncna…
@VincentRK one what federal government must do to prepare for the next battle: medicine shortages. nbcnews.com/think/amp/ncna…
1. We have a shortage of #PPE, testing, and treatments such as azithromycin and hydroxychloroquine, but as more patients are admitted to the ICU, we now have a shortage of other common medications used in ICU, and specifically, to place a person on a ventilator.
2. "Albuterol, used for wheezing illnesses like asthma, is already experiencing a national shortage...and midazolam and propofol — drugs needed to induce and maintain sleepiness and comfort while on a ventilator." Note: being on a ventilator w/out proper medication is inhumane.
3. This is where we realize how broken the U.S. system is. "Many of the shortages are going to be generic drugs, where unlike the rest of the world, we have only a limited number of authorized versions available." @US_FDA needs a 24-hour turnaround to approve imported generics.
4. The authors call on the feds to ask major pharmas to "boost mass manufacturing of approved drugs that are in short supply." If this is not done amicably, "the administration must default to the Defense Production Act to compel mass production."
5. Friendly reminder that China makes many of the ingredients for the drugs we need. "U.S. must consider increasing the manufacture of active ingredients within the country to decrease production times of important drugs." In the interim, we need to assess and pool our stockpile.
6. Oh, but wait. In the U.S. we have a wonky system for pricing. The authors propose that "Medicare must be allowed to negotiate a single price for COVID drugs and companies could be given a “Netflix” option, in which they receive a fixed contract for an unlimited supply."
7. Pharmacy benefit managers (PBMs). "the middle men between drug manufacturers, pharmacies & insurers" favor $$$ drugs. "Fed govt must prohibit deductibles & rebates for COVID-specific drugs + ensure that large pharmacy chains sell these medications at manufacturer price.
8. Another argument for a national database: "For critical hospital medications, the government should establish centralized systems to track need, based on patient caseload, inform manufacturing needs, and shift supply rapidly and equitably." States & cities will need to share.
9. It's hard to see how we don't emerge from this crisis without some form of national healthcare infrastructure. Right now we desperately need a new approach to data sharing, reserves (PPE, Vents, medicines), and pricing. But the truth is, we have always needed this.
We'll cover medicine shortages in more detail at 6pm in the CovidX Daily Digest. Initially distributed to key decision makers in government, the private sector, and philanthropies, it is now open to all: covidx.org or follow @covid_x
