Doctors Group Supports Fight on Drug Shortages

The American Medical Association threw its support behind government efforts to ensure the supply of lifesaving medicines but stopped short of recommending financial penalties against drug companies.

The influential doctors' lobby voted on Monday to back U.S. legislation to create an advance warning system of impending shortages that has been stuck in Congress.

The resolution, which declared the problem a national public health emergency, was a top agenda item at an AMA meeting in New Orleans. A worsening shortage of medicines used in chemotherapy, among other drugs, has forced doctors to delay treatment or use second-best alternatives.

The AMA also signed off on a plan to lobby for the U.S. Food and Drug Administration and Congress to require drugmakers to develop contingency plans and other ways to continuously supply vital drugs and vaccines.

A draft resolution had additionally recommended financial penalties on drug companies that do not increase their production of medicines in short supply within 30 days.

"We want to encourage manufacturers to invest... and encourage them to produce medications, and threatening them with penalties is not the way to do it," Dr. Benjamin Whitten of the Minnesota Medical Association said during the debate.

Instead, the AMA aligned with other medical groups in suggesting financial incentives for drugmakers to continue production of scarce medicines, which are often cheaper and older generic drugs with low profit margins.

"(Penalties) wouldn't make a difference, they'd just quit," delegate Dr. Floyd Buras Jr., president of the Louisiana State Medical Society, told Reuters ahead of the vote.

Other delegates agreed that the problem may be too dire to threaten drugmakers with penalties at the risk of giving them grounds to quit production altogether. A new study shows that although 100 companies supply the drugs that are experiencing shortages, half of them come from just one or two companies.

Some 200 drugs are in shortage in the United States, compared with 56 that were reported as scarce to the Food and Drug Administration in 2006. The deepening problem led President Barack Obama to sign an executive order to address it.

The order reflects congressional proposals but lacks the authority of legislation.
"That's the president talking to his agencies. That's not a change in a law and you need a law," said Bona Benjamin, director of medication use quality improvement at the American Society of Health-System Pharmacists.

She said the AMA's support could help the pending legislation given the organization's considerable influence.

"We are encouraging legislation that would be at least in part a solution to this," Dr. Jeremy Lazarus, private-practice psychiatrist in Denver and incoming AMA president.

"Our doctors want to take care of their patients in an effective way and have the medicines available to them that they need... and we're throwing our weight behind trying to make that happen."

He said the vote was based on a comprehensive report that shared no data on impacts of imposing penalties on drugmakers but clearly showed that early warnings worked. The FDA has said that so far this year the agency has been able to prevent 99 shortages thanks to the voluntary early notices of upcoming scarcities, which would be required by the law.

Some 500 representatives to the AMA House of Delegates on Monday also got behind a fight against another issue deemed a national public health emergency, abuse of painkillers.

They voted to promote doctor training on proper use of controlled substances and encourage physicians to check their states' databases for any history involving their patients and controlled substances.

Abuse of prescription painkillers has been on a dramatic climb in recent years, killing nearly 15,000 Americans in 2008, a record that is more than illegal drugs such as cocaine and heroin combined.