Could Drug Shortages Be Related to Y2K-Related Problems? (Long) : LUSENET : Grassroots Information Coordination Center (GICC) : One Thread

This posting includes a very long list of URLs pertaining primarily to drug shortages. A general statement on the topic of drug shortages can be found on a recent thread on GICC now in the archives under "Health": "Y2K-related problems and the pharmaceutical industry? More predicted coincidences?" That thread is reprinted in part here as a preface to the list:

"Carl Jenkins posted a thread on GICC on March 30, 2001 entitled: Anesthesia drug shortage shrinks margin of safety The article was wideranging and mentioned other shortages beyond anesthesia.

This is one of a growing number of threads on problems in the pharmaceutical industry, problems of a sort that were predicted prior to January 1, 2000.

A summary of observations by an engineer in January of 2001 may well shed light on the root causes of some of the problems that are becoming evident in the pharmaceutical industry, not to mention other sectors. The summary is a result of an exchange I had with an engineer who has direct knowledge of IT and embedded control system problems in the field. Here is a excerpt from the summary:

"I said that I have been hearing about shortages in the pharmaceutical industry and asked (the engineer) if he thought this might be related to (Y2K-related) problems (involving) manufacturing processes. He said that there are manufacturing problems and that too many bugs have slowed manufacturing processes. He added that there is a major shortage of computer components and that the parts that are available are often parts that have been put back in stock even though they do not work. He said he has found the same to be the case when it comes to other technology companies and parts vendors...."

~ From 1/30/2001 Summary of an Engineer's Observations Regarding the Status of Ongoing Y2K-Related Embedded Systems and Complex Integrated Systems Problems Compiled by Paula Gordon (With a minor revision made 2/1/2001)

Note: The Summary of an Engineer's Observations..." is now posted at The summary focuses on problems of the sort that were predicted prior to the January 1, 2000 rollover have been occurring in a wide range of sectors. This summary of observations of an engineer provides abundant clues concerning the possible causes of problems that are evident in the energy sector and in other sectors as well. "

End of quote from the previous GICC thread


The following list of references appears here owing to the extraordinary efforts of Murray Charters of Toronto, Canada. Gail Vass was instrumental in helping coordinate this volunteer effort and bring it to fruition. Thanks to them both. I hope that this list of references will be widely circulated and prove helpful to many.

The majority of these references pertain to drug shortages or sources of information concerning drug shortages. I have also included a list of references that pertain to meningitis and a briefer list that pertains to Parkinson's Disease, subjects of particular interest to Mr. Charters.

* spot shortage of certain hemophilia factor products

October 29, 1999 Shortage of Intravenous Penicillin G -- United States

Drug shortage hits Vanni hospital [TamilNet, June 28, 2000 15:47 GMT]

Saving Lives When a Drug is in Short Supply June 30, 2000 Drug Shortages - Contents

Current Drug Shortage List - Drug Shortages June 30, 2000

New York Times Jan. 03, 2001 Drug Shortages Become Worry at Hospitals Around the Country

Thursday February 8, 3:00 pm Eastern Time BusinessWeek Online THE BIOTECH BEAT -- Immunex' Supply-Side Cliffhanger

Patients vs profits as drug wars start

Wall Street Journal WASHINGTON, March 6 - Hospitals in several areas of the country are experiencing dire shortages of some anesthetics and other drugs used during surgery, forcing some to reschedule medical operations.

Monday March 12 09:26 PM EST Anesthetic Shortage In Hospitals

Tuesday March 27 5:38 PM ET FDA Says Anesthetic Shortage Resolved

Wednesday March 28 03:22 AM EST Some Hospital Drugs In Short Supply

Anesthesia drug shortage shrinks margin of safety March 29, 2001 Anesthesiologists are concerned about the shortage of key drugs needed for patients during surgery

Monday April 2 5:53 PM ET Experimental Egg-Free Flu Vaccine Promising

Wednesday April 4, 6:02 am Eastern Time CenterWatch Forecasts Shortage of Clinical Trial Investigators by 2005

Thursday April 5 1:25 PM ET UK Outbreak of Tuberculosis Worst for Many Years

U.S. Food and Drug Administration Center for Drug Evaluation and Research - Drug Shortages

Pharmacy shelves emptying - January 15, 2001 Manufacturing problems increase drug shortages

House of Representatives Prescription Drug Task Force

FDA Drug Shortages Page

FDA Product Recalls, Alerts, and Warnings. FDA posts press releases and other notices of recalls from the firms involved as a service to consumers, the media, and other interested parties.

American Society of Health-System Pharmacists Drug Product Shortage Management Resource Center (Scroll down for Bullitens and Links)

Drug Shortages Seem Plentiful, Frequent BETHESDA, MD, 7 April 2000

lmproving drug supply in the province, 28 March 2001

In Africa, price just one obstacle to AIDS drugs - April 2, 2001

Pentagon to limit anthrax shots in face of vaccine shortage - July 10, 2000

Senate panel examines Pentagon anthrax vaccine shortage (12-Jul-00)

April 6, 2001, Drug Shortage Alert, FDA:

Drug Shortage

Anesthesiologists Call for Investigation of Widespread Shortages of Anesthetic Drugs PARK RIDGE, Ill. (March 5, 2001)

The Case Of The Curious Drug Shortage

Drug shortage causes rationing WASHINGTON (AP) Tuesday, February 20, 2001

Vaccine Shortages - Tetanus shots is short supply

Thursday, June 17, 1999 Delhi govt's drug policy -- A hit with everybody but MCD

Pharmaceutical shortfalls trigger treatment dilemmas Many drugs are in short supply, and the solutions to the complex problem are elusive. By Susan J. Landers, AMNews staff. March 26, 2001

Is drug shortage spreading?

ASHP Calls for Drug-Shortage Experience Reports for 2000 Annual Meeting BETHESDA, MD, 14 January 2000-Do you have a practical strategy to share on dealing with drug product shortages, including short- and long-term back orders and products that are constantly unavailable? ASHP can use your in put for the special pearls session "Creative Strategies for Dealing with Drug Shortages" to be held at the upcoming Annual Meeting 2000 in Philadelphia this June. Suggested topics include working with your administration, group purchasing organization, prime vendors and other distributors, pharmacy and therapeutics committee, chiefs of services, medical staff, and nursing and inservice education departments. Please contact Joseph Deffenbaugh, at 301-657-3000 ext. 1250, for more information.


Institute for Safe Mediciation Practices (ISMP®) ISMP MEDICATION SAFETY ALERT! Volume 6, Issue 5 March 7, 2001 March 5, the American Society of Anesthesiology contacted the FDA and US Drug Enforcement Agency, the Pharmaceutical Research and Manufacturers of America, and several anesthetic manufacturers and distributors asking them to participate in an immediate fact-finding mission to put an end to the critical drug shortage . A meeting date has not been set. Last month, over 300 practitioners responded to our survey on drug shortages and its impact on patient safety and interdisciplinary professional relationships. Look for the results in the next edition of the newsletter.

Tetanus vaccine in short supply

Rabies claims more Afghan victims At least 80 people were attacked by dogs in March, but there is not enough vaccine April 10, 2001

UK parents warned on TB April 6, 2001 The government recently announced it would resume the routine immunisation of schoolchildren against TB, which was halted in 1999 because manufacturing problems led to a shortage of the Bacillus Calmette-Guerin (BCG) vaccine.

And... drugs aren't the only shortages.....

Health Care Issues

'Frightening' U.S. blood shortage delaying surgery September 19, 2000

Houston blood shortage delays surgeries April 6, 2001

Wednesday 11 April 2001 NHS staff crisis worsens despite cash injection

Tuesday, April 10, 2001 Nursing shortage affects nonprofit hospitals' fiscal positions

Tuesday, April 10, 2001 Don't take doctors, S. Africa begs,1249,270011369,00.html?

Tuesday, April 10, 2001 Nomadic 'travel nurses' fill shortages at hospitals Their rent paid at ever-changing locales, the calling suits many.

Tuesday, Apr. 10, 2001 at 01:34 CDT More hospitals may sue insurers (cash shortfall)

January 14, 2001 Hospitals' nurse shortage is starting to affect patients

April 8, 2001 Citing nursing shortage, man sues Norfolk hospital

Sunday April 08 10:44 PM EDT Nursing Shortage Is Raising Worries on Patients' Care By MILT FREUDENHEIM and LINDA VILLAROSA The New York Times

Sunday, April 08, 2001 Nation's nurse shortage fuels concerns over patient care,1249,270011055,00.html?

Shortage of nurses ails Iowa 04/04/2001 By TONY LEYS Register Staff Writer

AMSA: Bush Should Protect, Expand Health Service Corps as Solution to Health Disparities, Access Crises

Drugs in Short Supply

Thursday, December 21, 2000 Arthritis patients warned new drug in short supply

Dragging feet on drug shortage? Sunday, February 25, 2001

'No Drug Shortage At RVH' Daily Observer (Banjul) March 1, 2001

Prescription drug shortage plagues area hospitals

No drug shortage in local hospitals

Availability of Influenza Virus Vaccine 2000-2001

Why Is There a Flu Vaccine Shortage?

Treatment Prevents Flu FDA: Flu Treatment Drug Can Prevent Illness, Too

Flu Vacine Shortage is Due to Low Price Not Manufacturing Problems


FDA Finds Problems at Lilly's Injectable Products Plant

Cycloserine caps ( a World Shortage drug )

Search WHO (type in +drug +problem +shortage) 100+ hits

The drugs business, like any other industry, is governed by the laws of supply and demand. If there is a shortage of raw material.... _trade/production/production.stm

Fair use for education and research use only British Medical Journal -Jan. 20, 2001 Prescription drug shortages plague US.(News) Author/s: Fred Charatan Issue: Jan 20, 2001 Prescription drug shortages have been worrying doctors, pharmacists, and federal regulators over the past six months, especially in the hospital sector. A few years ago a hospital might run short of one or two critical drugs a year, whereas in the past year the number has run to as many as two dozen drugs. In October, for example, Brigham and Women's Hospital in Boston found itself unable to buy sufficient supplies of oxytocin, which is used in almost every one of its 10 000 annual deliveries. Doctors therefore had to cut back on their use of the drug. Fortunately no patient suffered, said Dr David Acker, the hospital's chief of obstetrics. The University of Utah's hospitals and clinics ran out of flumazenil (Romazicon)--which is a benzodiazepine antagonist, used to reverse the central sedative effects of benzodiazepines, after anaesthetic and other procedures--and for which there is no generic equivalent. Flu vaccine was in short supply nationwide last year, when the four manufacturers licensed to make it had difficulty growing one of the three flu strains. Small distributors of the vaccine, according to hospitals, were asking $150 (100 [pounds sterling]) for a 10 dose vial, against the usual price of $20-$30 a vial.

The Centers for Disease Control and Prevention in Atlanta, asked for the first doses of available vaccine to be given to those at high risk of complications from flu, such as elderly people. Last November, in some south Florida towns, long queues of elderly people formed outside supermarkets and retail pharmacies where flu vaccine was advertised at $12 a shot bur ran out before the demand could be met. Many complained that their own doctors could not obtain the vaccine.

Some prescription drugs are imported from abroad and may be flawed in quality and potency. Congress passed the Prescription Drug Marketing Act in 1997, which tried to eliminate the "grey" market for drugs, under which small drug wholesale distributors obtain drugs often illegally, and resell them at large markups to hospitals unable to obtain them from regular suppliers. But regulators say that the law has been ineffective and is full of loopholes. Drugs in short supply that are sold on the grey market have been estimated to top $1bn (about 1% of total sales of prescription drugs in 1999).

The reasons for the shortage of prescription drugs include manufacturing difficulties; "just in time" inventories, whereby hospitals keep minimal supplies on hand to save outlays and storage space; and price inflation, which was particularly the case with flu vaccine. Such inflation has meant that hospitals and clinics cannot afford to buy the quantities that they need.

The American Society of Health System Pharmacists was so upset by the shortage of flu vaccine that it protested to the health and human services secretary, Donna Shalala. It complained that its members were not receiving any, or only a small proportion of, their orders, and yet flu vaccine was available in shopping malls, supermarkets, and other retail outlets.

Fred Charatan Florida The US Food and Drug Administration has set up a website to monitor drug shortages at COPYRIGHT 2001 British Medical Association

Genzyme remakes purchasing to maximize supply value

Inside FDA: When a Drug Is in Short Supply

ACC News January 1, 2001 Isoproterenol No Longer Available for Use in EP Studies

Naloxone Hydrochloride Shortage-Update 5 April 2001

Measures to address drug shortage in clinics, 18 April 2000

Drug Shortage Imagine you're at the hospital for a scheduled surgery or procedure. Everything's on course, but all of sudden, there's a problem: the hospital doesn't have the anesthetic your doctor wants to use or it's out of the medication used to treat your nausea or your having a baby and there's no drug available to induce birth. According to the New York Times, hospitals around the country are experiencing these problems and more. We speak to Bill Goveia, Pharmacy Director at New England Medical Center in Boston about the shrinking supply of many common prescription drugs.

Drug Shortages: ACTH for West's Syndrome in Babies

06/30/2000 | Drugs News/New Drugs | How To Find Drug Info | Related Info: Drug Regulations; Drug Safety Infantile spasms, or West's syndrome, is a sometimes crippling and even life-threatening seizure disorder that affects about 3,000 babies a year in the United States. The only drug that helps prevent the spasms is Acthar gel (ACTH), and that drug's only manufacturer is Rhone-Poulenc Rorer Pharmaceuticals Inc.

For several months in 1996, Rhone-Poulenc stopped making Acthar because of manufacturing difficulties. A crisis resulted, with insufficient supplies to treat patients with West's syndrome and other diseases.

While the company worked with the Food and Drug Administration to fix problems in its plant, the nonprofit National Organization for Rare Disorders helped dole out the very limited supplies for emergency cases of infantile spasms and other conditions. "During the shortage, even some people with severe pain from rheumatoid arthritis couldn't get the drug in favor of babies with life-threatening West's syndrome," says NORD president Abbey Meyers.

Severe drug shortages like this one are infrequent, but a minor supply problem creating a potential shortage usually arises about once or twice a month, says FDA's drug shortage coordinator, Mark Goldberger.

Hospitals Rationing Tetanus Shots Saving Shots Due to Vaccine Shortages By Lauran Neergaard The Associated Press W A S H I N G T O N, Feb. 19

Tetanus Toxoid Shortage-Update 23 March 2001

Tetanus is a dangerous, though quite rare, infection. Forty-one cases of tetanus were reported to the CDC in 1998, the last year that statistics are available. Infection carries a fatality rate of more than 30%.

This has been a problem in the past...

February 22, 1985 Diphtheria-Tetanus-Pertussis Vaccine Shortage

More recently....

December 28, 2000 - Tetanus-Diphtheria (Td) Shortage Continues The California Department of Health Services (CDHS) Immunization Branch has advised local health departments that the Td shortage may persist until late January or early February. CDC recommends that providers experiencing difficulty obtaining sufficient Td supplies prioritize use as follows: 1. Persons needing tetanus prophylaxis for wound management. 2. Persons traveling to countries where the risk of diphtheria is high (e.g. developing countries and countries of the former Soviet Union.) In addition, children 7 years and older needing Td for school entry should be immunized. According to the State Immunization Branch, pediatric DT contains the same quantity of tetanus toxoid and may be used if available. However, patients should be advised that due to the higher dose of diphtheria, there maybe an increased local reaction. If a health care provider is unable to obtain Td for wound management, single-antigen tetanus toxoid can be used. Unfortunately the Department of Public Health does not have a sufficient supply of Td to distribute to other health care providers. It is recommended that health care providers maintain a list to facilitate recalling low risk patients who are not immunized due to non-availability of Td.


Meningitis scare makes for long lines, short supplies

Feb. 16, 2001, 9:31AM Meningitis vaccines offer hope Researchers cite increased options

Grande Prairie, Alberta Two cases of meningitis confirmed Father and son diagnosed

Grande Prairie, Alberta - Infection confirmed

Meningitis vaccinations unlikely this school year

April 10, 2001 London, Ontario Mass inoculation begins The Middlesex-London Health Unit vaccinated thousands of university, college and high school students against the deadly meningococcal disease in London yesterday with few hitches.

April 12, London, Ontario - Students line up for immunizations Nearly 90 per cent of high school students have chosen to be vaccinated against the deadly meningococcal disease, health officials say

Friday 13 April 2001 B.C. wins approval for new vaccine The unlicensed drug will be used in mass immunization against meningitis

April 13, 2001 Precautions taken after Manitoba day care worker contracts meningitis

Friday, April 13, 2001 Updated 4:25 PM CDT Houston Chronicle - SPECIAL REPORT: Meningitis MENINGITIS VACCINATIONS RECOMMENDED FOR SOME

Meningitis: The argument for mass vaccinations

Meningococcal Disease among College Students October 20, 1999 Contact: (404) 639-3286 ACIP Modifies Recommendations for Meningitis Vaccination

Oct. 21, 1999 Panel urges college meningitis warning

Meningitis Vaccine 05/18/2000 Scientists believe that they are close to beating meningitis once and for all, it emerged last night. They are currently developing a vaccine against the most common deadly form, meningitis B.

August 28 2000 BRITAIN Meningitis C vaccine 'is not linked to deaths'

Viral disease is mild; bacterial is deadly Nov. 29, 2000 Meningitis can be caused by either a virus or a bacterium. While viral meningitis is relatively mild, bacterial meningitis is life-threatening and requires prompt treatment.

Monday January 29, 2001 Charles Mérieux, the French virologist who pioneered the large-scale industrial production of vaccines that have saved millions of lives, has died aged 94.,4273,4126211,00.html

Feb. 1, 2001, 10:00AM Meningitis scare makes for long lines, short supplies

Vaccination Against GROUP C MENINGOCOCCAL MENINGITIS and SEPTICAEMIA 9 February 2001 A new vaccine, called Men C, can protect against Group C meningitis and septicaemia. By the end of 2000, the vaccine will have been offered to everyone under 18 in the UK.

Millions at the mercy of drug giants By Sarah Boseley in Johannesburg Guardian Unlimited Wednesday February 14, 2001,4273,4136247,00.html

Feb. 16, 2001, 9:31AM Meningitis vaccines offer hope Researchers cite increased options

DBMD - Meningococcal Disease - General Information Summary: Meningitis is usually caused by a viral or bacterial infection. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. 16254 bytes, updated 03-10-2001

Sunday, 18 March, 2001, 14:28 GMT Meningitis epidemic hits Burkina Faso

Thursday, 29 March, 2001, 17:00 GMT 18:00 UK Burkina Faso meningitis deaths top 900 The meningitis epidemic affecting Burkina Faso has continued to worsen.

Grande Prairie, Alberta Two cases of meningitis confirmed Father and son diagnosed

Grande Prairie, Alberta - Infection confirmed

Meningitis vaccinations unlikely this school year

April 10, 2001 London, Ontario Mass inoculation begins The Middlesex-London Health Unit vaccinated thousands of university, college and high school students against the deadly meningococcal disease in London yesterday with few hitches.

Wednesday, 11 April, 2001, 15:40 GMT 16:40 UK 1,200 meningitis deaths in Burkina Faso

12-Apr-01 Meningitis Deaths Set Weekly Record An upsurge in a meningitis epidemic that doctors thought was under control killed 241 people in the last week, bringing the death toll in Burkina Faso this year to 1,379, official figures showed.

April 12, London, Ontario - Students line up for immunizations Nearly 90 per cent of high school students have chosen to be vaccinated against the deadly meningococcal disease, health officials say

Friday | April 13, 2001 What Jailan Smith can teach us Missed by new vaccine, toddler struggles to recover from preventable form of meningitis

EC Funds Meningitis Campaigns in Chad, Burkina Faso UN Integrated Regional Information Network (Nairobi) April 13, 2001

April 13, 2001 Meningitis Epidemic Spreading Ethiopia faces a major meningitis epidemic unless international donors meet the current shortfall in vaccines, the UN Country Team for Ethiopia has warned

Nashville - Meningitis sends Vanderbilt student to hospital April 13, 2001

Friday 13 April 2001 B.C. wins approval for new vaccine The unlicensed drug will be used in mass immunization against meningitis

April 13, 2001 Precautions taken after Manitoba day care worker contracts meningitis

Meningitis strikes day care worker More than five dozen families in River Heights are administering antibiotics to their children today

Monday, 31 January, 2000, 14:19 GMT The meningitis files

Friday, April 13, 2001 Updated 4:25 PM CDT Houston Chronicle - SPECIAL REPORT: Meningitis MENINGITIS VACCINATIONS RECOMMENDED FOR SOME

WHO Outbreak News Index - Meningococcal disease

Everything You Ever Wanted to Know About Meningitis

Meningitis Foundation of America offers support and comprehensive information on this disease.

The Meningitis Research Foundation of Canada

Are There Vaccinations for Meningitis?

Meningitis Research Foundation welcomes you to its Website

Meningitis "Polio has not been eradicated by vaccination, it is lurking behind a redefinition and new diagnostic names like viral or aseptic meningitis

NIH Meningitis Links

PARKINSONS DISEASE REFERENCES (scroll down to read latest 500 posts online)

parkinson resources on the wwweb


Nov. 5, 1999 FDA panel OKs new child vaccine - Prevenar

March 2, 2000 Drug firms boost vaccine donations

Feb. 28th. 2000 Vaccine cleared for pneumococcal disease

-- Paula Gordon (, April 14, 2001


Paula, I thought I had tenacity, You put me to shame You Go Girl, before the Web Masters, seek to erase our words. You Go, Girl!

-- My Sorry (, April 14, 2001.


In the recent post from regarding shortages of Fentanyl and other anesthesia drugs, there was a quote that the FDA would be assisting the drug manufacturers in obtaining the "raw materials". It implied the cause of the drug shortages was inability of the manufacturers to get the raw materials.


-- slza (, April 14, 2001.

Correction: Murray Charters, who so diligently searched out most all of the many URL's in the list above, lives in Vancouver, not Toronto as I had noted.

-- Paula Gordon (, April 15, 2001.

Paula, how are blood shortages caused by embedded problems? Except that people don't go down and get needles embedded into their arms to donate.

There is not and never has been a Y2K problem caused by the much hyped Y2K "embedded" problem.

Get a grip. The reason they can't get anyone who knows what is wrong with their equipment is because the last generation went for the quick big bucks-little effort-brains fields "information Technology" (glorified data processor) instead of getting into a field like digital electronics where it takes an effort and a brain to understand and accomplish the job.

-- Cherri (, April 15, 2001.

Paula, How is a shortage of nurses related to Y2K? I'd say its more an issue of low unemployment and poor working conditions in the field.

-- John Littmann (LITTMANNJOHNTL@AOL.COM), April 15, 2001.

Thanks for the postings. In the opening sentence I noted that the "posting includes a very long list of URLs pertaining primarily to drug shortages." I simply did not take the time to edit those items out of Mr. Charters' compilation that are unrelated to drug shortages.

-- Paula Gordon (, April 15, 2001.

The answer would be, in one word, NO.....

-- Rob (, April 16, 2001.

New post of interest on GICC entitled "Drug Shortages?" from Martin Thompson on 4-22-2001:

-- Paula Gordon (, April 22, 2001.

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