The novel coronavirus has put an enormous strain on the pharmaceutical supply chain, with spot shortages of certain meds increasingly common. Now, with thousands of COVID-19 patients flooding U.S. hospitals, drugs used during treatment and ventilation are growing scarce.
Increased demand for drugs used in hospitals as painkillers and surgical anesthetics for patients with COVID-19 have sapped supply, potentially threatening access for months.
Friday, the FDA posted updated shortages of anesthetics propofol and midazolam, citing increased demand. For generic propofol, produced by a number of manufacturers, a resupply could occur as late as October with companies like Dr. Reddy's Laboratories and Hikma Pharmaceuticals unable to source active pharmaceutical ingredients for the drug, the FDA said.
For midazolam, meanwhile, certain doses are still available, according to the FDA, but other doses may not be until early 2021 at the latest.
The U.S. Drug Enforcement Agency (DEA) said last week it would allow increased production and imports of midazolam, a controlled substance, to combat ongoing shortages. The DEA included a range of painkillers and sedatives on its production increase list, including fentanyl, ketamine, phenobarbital and diazepam.
“DEA is committed to ensuring an adequate and uninterrupted supply of critical medications during this public health emergency,” acting DEA Administrator Uttam Dhillon said in a release. “This will ensure that manufacturers can increase production of these important drugs, should the need arise.”
The novel coronavirus pandemic has not only hit painkiller and anesthetic supplies but also asthma inhalers, according to the Washington Post.
Doctors attempting to keep patients off nebulizers caused a chain reaction that led to shortages of albuterol asthma inhalers in hospitals and retail pharmacies, the Post reported.
In the case of fentanyl, used to treat ventilated patients, hospitals require large 50-milligram doses of the opioid that quickly ran scarce, causing a cascade effect down the supply chain, according to the paper.
Shortages have become increasingly common for drugs tied to the coronavirus pandemic, including over-the-counter meds like Tylenol.
Last week, Johnson & Johnson reported a "temporary" scarcity of Tylenol after heightened demand strained supply, the drugmaker said in a statement. The shortage is limited to specific regions, and J&J said it would speed up production. J&J is working with retailers to "encourage" purchasing limits and is working to keep supplies running to consumers and hospitals.
The FDA previously reported shortages of hydroxychloroquine and chloroquine, antimalarial meds that have been targeted by President Donald Trump and others as front-runners for a possible COVID-19 therapeutic.
Other approved drugs and investigational candidates––including Gilead Sciences' therapeutic hopeful remdesivir––have neared shortages as the push for a COVID-19 therapeutic continues. Last week, Gilead said it had stepped up production of remdesivir to meet heightened demand, pledging to donate 1.5 million doses of the drug ready or nearly ready for shipment.