UNPROFITABLE DRUGS DANGEROUSLY SCARCE IN HOSPITALS

WASHINGTON -- Shortages of drugs commonly used in hospitals are putting
patients at risk across the country and forcing doctors and nurses to
ration their limited supplies.

Although some shortages stem from temporary manufacturing or distribution
problems, many are the result of profound shifts in the economics of the
pharmaceutical industry.

In response to increasing financial pressures, drug makers are abandoning
older, less profitable products used mainly in hospitals in favor of newer,
more lucrative medications tailored to the outpatient market. Government
regulators have no authority to prevent drug makers from halting production.

Only in rare cases can they even require that manufacturers give notice
before dropping products so that doctors have time to find substitutes.

Aggravating the problem, hospitals have responded to cost-cutting mandates
from managed-care insurers and the federal government by keeping
increasingly small amounts of expensive drugs in their inventories. This
management strategy has left hospitals with scant reserves when new
supplies were unavailable.

Although there have been no reports of deaths related to drug shortages,
doctors, pharmacists and critical-care unit managers in several cities say
the problem has threatened patient care.

Hospital pharmacists and doctors say the problem has reached the point
where government intervention is needed, if only to give hospitals more
warning of impending shortages.

PhRMA, the pharmaceutical industry's trade association, recently convened a
meeting to discuss the issue with FDA staffers, doctors, pharmacists and
hospital representatives.

"We can't comment on the shortages," PhRMA spokeswoman Jackie Cottrell
said. "There could be a variety of different reasons for different drugs.
We really have no information, and individual companies have to address it
for their individual circumstances."