In 2010, the primary provider of lipids used in American hospitals noticed that they weren’t very profitable… so they stopped producing them. I guess they’re allowed to do that. The main problem though was that the FDA took almost 4 years from that point to agree that US hospitals were allowed to import European lipids (fats) for feeding patients who could only eat via IV feeding solutions (otherwise called Total Parenteral Nutrition or TPN).
In the intervening years, hospitals simply fed patients pure dextrose, vitamins, and amino acids with no fats to buffer the insulin shocks these incomplete formulas caused. Most patients in this situation quickly lost skin elasticity, had their hair weaken / fall out, or in the most extreme cases, patients could begin suffering macular degeneration or accelerated diabetes symptoms.
Fortunately for hospital administrators, patients on TPN have such poor outcomes already that individual families probably couldn’t reliably connect their loved ones’ more rapid declines in health directly to the incomplete feeding formulas hospitals were supplying them. And even though it sounds absurd that there could be FDA-induced drug shortages for basic medical supplies in the US, unfortunately, this has only become more common over time.
In 2010 there were 178 drug shortages reported to the FDA of which 132 were sterile injectable drugs. The number of reported shortages increased to 251 in 2011, 183 of which involved sterile injectable drugs. As of February 28, 2013 there were 324 medications in short supply and of these 228 (70%) are sterile injectables. All PN products except dextrose and water have been in short supply at some point since spring of 2010.
Translation: US healthcare regulators aren’t even trying. Basic products like saline and lipids have gone into shortages due to the FDA setting up a system that can never self-correct with market forces. Instead, problems can only be fixed in a reactionary manner, months or years after disaster strikes via emergency FDA action to temporarily allow imports after shortages become intolerable. This gives the FDA several opportunities a year to announce that they have heroically ended drug shortages… while ignoring that their policies insured the shortages would be created in the first place.
And of course, no other first world country suffers these types of shortages because no other country prohibits importation of basic medical supplies. If this was happening anywhere else in the world, we’d be airlifting supplies and dropping them directly to the people as a humanitarian response. But because it’s America, we all just shrug and say something about how our healthcare system is “broken”.