Here at Healthlink Advocates, we try to stay on top of the latest medical news so that our clients are informed and protected. As a nurse patient advocate, I continue to be amazed at the drug manufacturing side of things.
I read two news reports this week in Becker’s Hospital Review that caught my eye with the following headlines:
“It's almost unfathomable in modern medicine': US hospitals running low on lifesaving drugs”
“Sanofi recalls heartburn drug over cancer risks”
Let’s start with the first headline. How could a hospital be running low on lifesaving drugs? The article reports that there are 116 drugs currently running low, according to the FDA. The article went on to discuss how Massachusetts General Hospital is two weeks away from canceling life-saving cardiac surgeries due to a shortage of heparin, a blood thinner, and necessary for this procedure.
“Drug shortages are increasing and lasting longer, according to an FDA report published Oct. 29. Of 163 drugs running low in 2013-17, over 62 percent was due to manufacturing or product quality problems.” The FDA further notes that drug manufacturers have little incentive to produce older drugs that cost less, so there are only a few manufacturers producing these drugs.
The significance of this is very clear! Without some of these older drugs, the affect is widespread. The performance of surgeries and procedures is affected as well as patient treatment. Are these older and less expensive drugs being priced out so that the vulnerable patient will only have access to expensive drugs or worse yet are life-saving procedures not going to be readily available?
The second headline is one I am seeing more often and is equally disturbing. The FDA requested a voluntary recall of the drug Zantac (ranitidine) due to finding trace amounts of N-Nitrosodimethylamine (NDMA), which is classified as a probable human carcinogen. Not all Zantac has been recalled and no reported adverse events have been reported either. You should check with your physician, pharmacist and the FDA website for more information. Please refer to the FDA website for details and what the FDA has published as to what you should know about this recall. https://www.fda.gov/drugs/drug-safety-and-availability/questions-and-answers-ndma-impurities-ranitidine-commonly-known-zantac
What patients should know about NDMA impurities in ranitidine
Not all ranitidine medicines marketed in the U.S. are being recalled.
FDA has advised companies to recall their ranitidine if testing shows levels of NDMA above the acceptable daily intake (96 ng or 0.32 parts per million for ranitidine).
Some companies have recalled ranitidine based on tests showing levels of NDMA above the acceptable daily intake, while some have recalled without doing testing based only on the potential for NDMA in the drug.
Consumers may not know if the over-the-counter (OTC) ranitidine in their homes contains NDMA above the acceptable daily intake level because these recalls have been to the retail level, meaning they were only removed from store shelves. However, the NDMA levels we’ve found are similar to the levels you would expect to be exposed to if you ate common foods like grilled and smoked meats.
Consumers taking OTC ranitidine may consider using other OTC products approved for their condition. To date, FDA’s tests of samples of alternatives show no NDMA in: Pepcid (famotidine), Tagamet (cimetidine), Nexium (esomeprazole), Prevacid (lansoprazole) and Prilosec (omeprazole).
Patients taking prescription ranitidine who wish to stop should talk to their health care professional about other treatment options. Multiple drugs are approved for the same or similar uses as ranitidine.
I’d like to end on a more positive note and share an important resource for getting the best price for your medications. There is a website called GoodRx at www.goodrx.com where you can make sure you are getting the best prices on your medications. You can even have the app on your smartphone and review it at the pharmacy! If you are on Medicare, this is a good time of year to check that your drug plan is the best most cost effective plan for next year. Prices and drug tiers can change from year to year and significantly affect the medication costs so it is wise to check every year. Watch this video to learn how GoodRx works. https://www.goodrx.com/how-goodrx-works