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Local Health Officials Applaud President's Drug Shortage Directive

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CEDAR RAPIDS, Iowa - President Obama signed an executive order on Monday designed to help reduce a growing number of prescription drug shortages. But hospital pharmacy directors at both Cedar Rapids hospitals said it may take many months for that order to improve the current shortage situation.

The President's order to the Food and Drug Administration (FDA) was primarily designed to do three things.

Number one is to protect patients from possible price gouging by the drug industry. The U.S. Justice Department will examine whether specific drug shortages are tied to an intentional stockpiling of medications designed to manipulate supply.

The FDA reported 178 shortages of various medications in 2010—that's about triple the number as recently as 2005. The second and third goals of the directive is to require the FDA to better report possible drug shortages to avoid a surprise impact on the nation's health care system and to speed up regulatory reviews so medications can get to market quicker.

Desmond Waters, pharmacy director at Mercy Medical Center in Cedar Rapids, said the shortage problem has worsened in recent months. He figures at least 200 medications are on a watch list now—meaning they're becoming harder to obtain. Another 60 or so are on what's considered a critical list with physicians advised to find an alternative if possible. Waters said at estimated eight to ten aren't available at any reasonable price.

"Sometimes, there's only one or two major manufacturers who make a specific product and if one is not available it puts the entire market into a shortage," Waters said.

The problem with turning around the sporadic shortages is the lead time it takes to manufacture an increased supply. Some common cancer drugs have become difficult to obtain and in many cases, it's the more difficult-to-manufacture injectable versions of drugs that are the real problem.

At St. Luke's Hospital, two empty bins in the pharmacy department contain drugs used to help low birth weight babies gain weight. In those cases, there are no substitutes.

St. Luke's Pharmacy director Pat Thies welcomes some federal input on the issue.

"I think all three (Obama directives) put together will probably make a significant impact in the future. What I don't really see is how it will impact us in the short term—the next six to nine months."

Thies said both hospital pharmacies are cooperating to weather the drug shortage situation. Sometimes, doctors can readily fine a good substitute. And sometimes you can't.

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