Thanks to my first post on organ donations and executions, the stories generated by my news algorithm have taken on a capital-punishment-y nature. Thus I was first alerted to the problem with Sodium thiopental, one of the three drugs used in executions (the other two are Pancuronium bromide and Potassium chloride). Hospira was apparently the only company in America that produced the drug and when they stopped production in 2009, various states turned to a London based company.
Apparently the drugs produced by that company, Dream Pharma, are of questionable quality and legality, prompting the DEA to size various states' sodium thiopental supplies and delaying executions across the country. My home state, Georgia, was first to be investigated, followed by Tennessee and Kentucky because they apparently bought from Georgia's supply. Other states are either giving up their supply to the DEA or switching their drug cocktail (which can cause its own problems).
Depending on your views on capital punishment, you may think this shortage is a good thing. But it's indicative of a larger, troubling trend of drug shortages because cost of production exceeds profits. If you live in Alabama, Arizona, Louisiana, Texas, or any of the other states that the coral snake is found in, be extra careful. The last vial of anti-venom expired in October of 2010 with no signs of a replacement source appearing anytime soon. Occasionally, the problem is with a shaky supply chain. For instance, Arizona ran out of scorpion anti-venom because only Marilyn Bloom was producing it and she retired. But by far, the most common culprit is economics. There are maybe 100 coral snake bites a year that require the anti-venom, so the cure was never destined to be a big money maker. But now that Wyeth has stopped production completely, any company looking to be the new source has to pay and pass the multi-million dollar hurdles involved with getting a drug past the FDA approval process. But why would any company do that if it has been clearly proven that this product has no chance of ever being profitable?
This begs the question: Who should be responsible for producing things that are not profitable, yet are still necessary? The first thought that springs to mind is that the government should subsidize it, like they do for mass transit, parks, museums, and other infrastructure and amenities. However, if the government did pay to manufacture anti-venom or other unprofitable but necessary drugs, it would cross a line that would be difficult to re-draw. Would the government limit itself to just production of already known drugs or would it also take on the extremely expensive task of searching for new ones? Would it only produce drugs with expired patents or would it be allowed to ignore patents completely if there isn't a profit to be had and essentially become rogue generic manufacturer? Why would drug companies, the so called "Big Pharma," continue to chase after those ever increasingly more expensive cures if there is some other source that can constantly afford a loss? Except (currently policies notwithstanding) the government can't operate at a loss indefinitely and eventually the whole structure will come crashing down.
So. We need to come up with a solution. Ideas? For now the most effective thing I can think of is avoiding anything that might be venomous and rare. If that fails, kill it with fire. Long term outlooks on this strategy are not so good, so other suggesting are eagerly welcome.
One last note on sodium thiopental. The shortage is occurring because Hospira and many other companies that manufacture the drug are facing boycotts from European governments that belong to the EU. As the EU is opposed to execution, member countries refuse to buy from those companies unless the company can ensure that none of its drugs will be used in lethal injections. However, states have mostly side-stepped this issue by using other barbiturates, and sodium thiopental has other uses. In fact, it is listed in the WHO's list of essential medicines, meaning that it is needed for a basic health care system. I hope that no one has been adversely affected because of this shortage.
NOTE: This post DOES NOT mean that I am for or against capital punishment. It merely means that I am interested in the economics of drug design.
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