Parents in the US are now confronting the challenges of a second year without an adequate supply of amoxicillin, the most commonly prescribed antibiotic in the nation.
The liquid versions of this medication, essential for treating children with strep throat, chest and sinus infections, and earaches, remain scarce according to the drug shortage database of the US Food and Drug Administration.
Unfortunately, there is no indication that this shortage will be resolved anytime soon.
“It is a problem. Respiratory illness season is coming up, and that’s going to be a huge issue,” said David Margraf, a pharmaceutical research scientist with the University of Minnesota’s Resilient Drug Supply Project.
Amoxicillin capsules and tablets have not been affected by the shortage, according to the FDA, but young children often can’t swallow pills and instead rely on liquids.
Not all of the manufacturers of amoxicillin powder, which is mixed to make the liquid form, have provided reasons for the shortfalls. Most are still producing the antibiotic but have it on allocation, which means their customers can order only a limited amount.
During a drug shortage, allocation helps ensure that no single buyer can claim all the available supply. But it also means pharmacies may run out quickly, creating a frustrating situation for parents and pediatricians who have been left searching for any available stock or who must then get a prescription switched to a different antibiotic.
“When there are these big surges in respiratory viral illness, in ear infections and all the things that come with the winter months of the last year or two, the demand has really outweighed what our supply chains can produce. And as a result, the shortages are cropping up all over the country and affecting our patients,” said Dr. Rohan Khazanchi, a pediatrician and medical resident at Brigham & Women’s Hospital in Boston.
Khazanchi and his colleague Dr. Ryan Brewster recently studied the clinical effects of last winter’s amoxicillin shortage. They found that after the FDA declared amoxicillin to be in shortage in October, prescriptions for it dropped more than 90% as doctors pivoted to sometimes stronger antibiotics like augmentin and cefdinir. These substitutions can result in harsher side effects for patients and can contribute to antibiotic resistance. They can also create a domino effect if the sudden shift in demand wipes out supplies of substitutes.
Amoxicillin isn’t the worst-case scenario for drug shortages; at least doctors have other antibiotics they can prescribe.
“What worries us is sort of the generalizability of this issue,” Khazanchi said. “It’s not about the amoxicillin; it’s about the fact that we have drug shortages for reasonably essential medications that are generic and should be widely available.”
Teva Pharmaceuticals attributed the shortage to a surge in demand rather than the usual causes such as manufacturing delays or raw material sourcing issues.
Sandoz, a subsidiary of Novartis specializing in generic drugs, pointed to competitive pricing as a factor pushing manufacturers out of the market, with a typical treatment costing around $10 per bottle.
“Drug shortages will likely continue to increase if the pricing dynamics in the marketplace are not addressed,” Sandoz said in a statement.
Other companies reporting shortages have declined to reveal the reasons for the supply squeeze.
“The companies refuse to tell us what’s going on,” said Erin Fox, who tracks drug shortages at the University of Utah. “We are absolutely heading into the season without good supplies of oral liquid.”
The amoxicillin shortage has lingered under the radar, says Laura Bray, who runs the nonprofit Angels for Change, which works to solve drug shortages.
“From a medical standpoint, it doesn’t have the same sense of urgency to fix because there are alternatives,” she said. “And so that’s why people are really not talking about it as much as, say, the chemotherapy drugs where there are no alternatives, but the root cause is the same.”
Antibiotics like amoxicillin are 42% more likely to be in shortage than other types of drugs, according to a 2022 report from US Pharmacopeia.
And as with many other drugs that are vulnerable to shortages, amoxicillin’s undoing is that it is cheap.
“They’re just not profitable for these companies, so they focus our efforts on other areas. And we’re kind of stuck with, they can make whatever they want, based on a bottom-line number,” Margraf said.
Though the FDA monitors and reports drug shortages, it has limited authority to fix them.
The FDA said in a statement that it sympathizes with people who are affected by shortages and is doing what it can to help. “While the agency does not manufacture drugs and cannot require a pharmaceutical company to make a drug, make more of a drug, or change the distribution of a drug, the public should rest assured the FDA is working closely with numerous manufacturers, agencies, and others in the supply chain to understand, mitigate and prevent or reduce the impact of intermittent or increased demand of certain products.”
Bray and other experts said what the US really needs is a person or office in government keeping an eye on drug supplies, ensuring that the US will have adequate supplies of basic medicines when the nation needs them the most.
Take the US Department of Agriculture. “If it’s their job to know usage of grain and corn globally, and the yield of corn and grain, and how much we should have on hand so that bread can be made so we can have sandwiches, why don’t we have something like that for drugs?” Bray asked.
Other experts agree.
“There’s no single organization, party, government entity or otherwise that’s individually responsible for monitoring the entire supply chain. And that lack of visibility causes issues because there’s no coordination,” said Matt Christian, director of supply chain insights with US Pharmacopeia’s Medicines Supply Map project.
Another proposed solution involves giving drug companies some kind of subsidy or financial incentives — perhaps guaranteed large volume contracts — to make inexpensive, necessary medications.
“We do it for farmers. We give them plenty of subsidies. And we don’t want food shortages,” Margraf said. “Now, we need to do the same with drugs.”
Luckily, one company called JASE Medical is on a mission to change things
JASE Medical is a telemedicine company with a singular focus to change all of that. This platform offers access to basic emergency preparedness medications for every family in America.
JASE Medical has extensively researched and established a nationwide network of physicians specially trained to evaluate individual needs, diagnose conditions, and prescribe necessary medications for emergency preparedness.
These prescribed medications could potentially save lives for you and your loved ones, all conveniently accessible through the JASE Medical online portal.
Whether it’s allergies, pre-existing conditions, or uncertainty about medication usage, the JASE Medical physician network is equipped to address all concerns.
Their user-friendly platform ensures a seamless consultation process that typically takes just over five minutes to complete. Shortly after, your personalized JASE Case will be delivered right to your doorstep.
What’s in the JASE Case?
The kit contains the following antibiotic medications:
- Amoxicillin/Clavulanate.
- Azithromycin.
- Ciprofloxacin.
- Doxycycline.
- Metronidazole.
All medications carry a level of risk, but these five antibiotics were selected for their effectiveness and optimal patient safety.
Guidance from the CDC says it best: “Antibiotics … save lives, and when a patient needs antibiotics, the benefits usually outweigh the risks of side effects and antibiotic resistance.”
Are there instructions?
With your JASE Case comes a guidebook titled the “Emergency Antibiotic Guide.” As you turn the pages, you will find lists of infections that are treatable with the JASE Case antibiotics.
Here are some of the possibilities:
- Anthrax, plague and tularemia (resulting from bio-terror).
- Bite wounds.
- Cellulitis.
- Diverticulitis.
- Intra-abdominal infections.
- Tooth infections.
- Ear infections.
- Pneumonia.
- Sinusitis.
- Strep throat.
- Urinary tract infection.
- and more.
The idea is that when you have an emergency and do not have direct access to a health care provider, you can consult the handbook and use the medications. JASE Medical ensures that, when needed, you will take these medicines safely and effectively.
What about chronic conditions?
In addition to the JASE Case (antibiotics), the JASE Medical platform will address emergency preparedness medications for those with chronic medical conditions. JASE Medical’s same physician network is prepared to assess your condition and the need for appropriate preparedness medicines.
Ongoing support
Yes! JASE Medical is there. As part of its mission to prepare you medically, JASE Medical will provide unlimited ongoing support from their physician network for questions about any of the medications prescribed.
What about shelf life?
The good news about antibiotics is that they last longer than you think. The FDA’s Shelf Life Extension Program found that 88% of the drugs studied maintained their potency and safety beyond the published expiration date. The extended usability of these medications ranged from 5.5 years to as many as 23 years beyond their printed expiration!
The JASE Case antibiotics all carry the FDA’s required expiration dates. JASE Medical endorses those dates. The JASE Medical team suggests buying your initial supply and then using your regular refills to keep a rotating supply of fresh medication on hand. In this way, you will keep a basic supply of full-potency meds indefinitely and at little or no additional cost.
Value and peace of mind
At the end of the day, this is all about peace of mind and knowing that you are ready for the unexpected. Understanding that you have found a solution, priced at a fraction of what it would otherwise cost you, only adds to that peace of mind.
Go to JASEMedical.com and secure your emergency medications, an emergency antibiotic guide, unlimited physician consultation and a team of professionals who are on a mission.
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