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Baking Soda Shortage Has Hospitals Frantic, Delaying Treatments and Surgeries (arstechnica.com)
An anonymous reader quotes a report from Ars Technica: Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate -- aka, baking soda. The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February. The country's two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer's suppliers -- the issue was undisclosed due to confidentiality agreements. Amphastar's supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don't know when exactly supplies will be restored. They speculate that it will be no earlier than June or August. With the shortage of sodium bicarbonate, hospitals are postponing surgeries and chemotherapy treatments. A hospital in Mobile, Alabama, for example, postponed seven open-heart surgeries and sent one critically ill patient to another hospital due to the shortage.
Purity.
Your hair look like poop, Bob! - Wanker.
There are always shortages - it's just not apparent to the average Slashdotter. This page lists current and past drug shortages going back to 2010.
Here's the Canadian version.
There seems to be a similar site for the EU, though the page says most shortages are handled by the individual national governments. I'd check the French or German health websites, but I'm not good in those languages. The UK seems to have ceased tracking shortages.
W..w..W - Willy Waterloo washes Warren Wiggins who is washing Waldo Woo.
1. Purity. Guaranteed absolutely free of anything that could be dangerous if injected.
2. Sterility. No microbes. Hermetic seal container made free of life at the factory.
3. A paper trail saying where it was made, when, and who shipped it where, for use in identifying any contamination that does occur.
4. Someone who can be sued if all the above fails.
Is this shortage happening in countries with "socialized medicine", or just in free market America?
We don't have a free market medical system. We have a cronyist monopoly enforced by laws written by hospitals and pharma company. If the medical system produced computers, a PC would cost about the same as a Lamborghini.
There is :
- ensuring everything is done in a sterile environment
- ensuring its purity
- testing of batches
- tracing and tracking the whole process
- precise weighing and packaging
- ensuring everything is in tamper proof packaging
- auditing of the whole process
All the equipment used in the manufacture, testing, packaging and the people involved are also traced and certified, with everything going back to calibrated National Standards and tested annually (or more). The temperature, humidity, raw materials, etc etc etc etc etc are all tracked right through the whole system in triplicate.
This is not a "throw a teaspoon full in" and it will be all OK.
Ingesting something (and we all swallow a low of bugs, insects, dirt, etc every year) is totally different to having it injected into the blood stream,
You say "purity and packaging" as if it's no big deal. It's a very big deal for something you're going to inject into someone's bloodstream. Take some common fungal spores which might not even count as contamination in food, inject them into patients and you could be facing horrific medical consequences on a massive scale.
Post may contain irony: discontinue use if experiencing mood swings, nausea or elevated blood pressure.
Let's restate "purity" in terms that someone at your level will understand. It has less shit in it that shouldn't be there. Kind of important when you're using it in medical procedures, not so important in industrial procedures.
It's a perfectly simple concept to understand so I'm not sure why you're having so much trouble. If the stuff available from Wacko's Online Emporium was as pure as what's required for medical procedures, there wouldn't be A FUCKING SHORTAGE.
The problem is that medical services may require economies-of-scale such that having say 7 competitors in a given market, especially rural areas, is just not realistic. Medical services are just not the same market profile as manufacturing light-bulbs.
Personnel are not even so much the problem. Medical salaries are only a small percentage of total costs, and if a real shortage develops we could always turn on the H-1B spigot.
It's more about the total opaqueness of all pricing: nobody knows what anything costs. Pharma keeps insisting that "nobody actually pays $120,000 for Harvoni." My brother didn't, for example - but what did his insurance plan actually pay for it, and why aren't we allowed to find out? And if nobody actually pays it, why is that the advertised price?
We expect higher prices for newly branded compounds, but how can the supply of generic drugs, which anyone can make, be monopolized? What can't we have our prescriptions filled on the world market, through Amazon?
Well expressed. I recently looked into the price of rattlesnake antivenin in the US and was astounded to see it costing up to $10000 per vial. A little searching revealed the cost of production was estimated to be about $14.
Link to an article discussing the costs:
http://www.smithsonianmag.com/...
Link to a research paper by the person responsible for creating the antivenin:
https://www.researchgate.net/p...
When they came for the communists, I said "He's next door. Take him away. Goddam commies."
See, without the great and wise FDA's policies of looking out for the people by allowing the concentration of critical supplies and medicines into the hands of 2 such wise and benevolent entities we'd not be in a position where decisions made entirely for profit could affect the lives of the general public. As much as I hate to see people suffer, I almost wish there would be deaths as a result of this and that forced some legal light onto the situation. Critical basics that are free from patent should required to be multiply sourced to ensure a steady interruption free supply chain, not concentrated into one or two 'most' profitable and controllable streams.
errr....umm...*whooosh* *whoosh* Is this thing on ?
Purity.
Not exactly. Both food grade and pharma grade sodium bicarbonate are greater than 99% "pure". Many industrial producers make both food and pharma grade sodium bicarbonate, some of them on the same line and processed to the same purity level...
The difference is that Pharma grade sodium bicarbonate is specifically tested to assure very small levels of certain specific impurities** mostly to minimize potential issues with inconvenient formation of various precipitates and other complications in equipment (e.g., hemodialysis), or your body.
All that product testing/certification isn't cheap and is completely unnecessary if you are simply eating it. For example, if 0.05% of the impurity was NaCl or MgCl, that would *bad* in your blood, but if you ate the typical amount of bicarbonate, you wouldn't even notice that impurity.
**USP has specific tests for impurities such as Chloride (0.015%), Sulfur (0.015%), Aluminium (2ug/g), Arsenic (2ppm), Calcium (0.01%), Magnesium (0.004%), Copper (1ppm). Iron (5ppm), Ammonia (20ppm), Organics (0.01%), etc...
Yeah, but a lot of people would have those Lamborghinis. You wouldn't just buy a computer though. You'd make computer payments. You wouldn't just buy stuff online. You'd make a $0.50 copay for each $100.00 iTunes or Netflix purchase because nobody actually buys directly from online retailers. I'm just guessing at what things cost, because the price list is secret. You could apply for a new computer right around the same time every year, along with a bunch of other people, unless your computer broke down our you got married, or needed a computer for your child, or Congress had gas. Then it's hard to say. You wouldn't be on the internet unless it was in your network. Maybe your state would only support the Bing network, unless you wanted to pay a lot extra. You could Google if you really wanted to; but then your next computer payment would be higher. You get free antivirus though, so you use that to feed some kind of delusion that this is all working out for the best. Sometimes reality intrudes and you get depressed. Then you fork over a copay for a program from Big Gaming that may or may not cause your computer to self-destruct. If that happens, it's GAME OVER.
For all intensive purposes, "whom" is no longer a word. That begs the question, "who cares"?
The ordinary Walmart product is pure enough for human consumption, as a tooth powder and stomach remedy. My example is chemical reagent purity.
I once worked in the analytical laboratory at J.T. Baker as an analytical chemist. I personally tested NaHCO3 among many other chemicals to USP, FCC, and ACS standards. We had a warehouse with plenty of barrels of these kinds of commodities. Also, I seem to recall that the ordinary box of Arm&Hammer on the supermarket shelf is actually very high quality material, almost pure enough to use for creating primary standard grade sodium carbonate by baking out some water and CO2 at a specific temp.
Note that the costs to certify to USP grade are little different than for the other grades. It is important to understand that many chemicals which come into a chemical plant never require any further purification. In such cases, a portion is split off to be packaged as ACS, another portion goes in the USP bottles, etc. The remainder can be sold off as "Technical" grade if there isn't enough room to store it. If there is room, it might be preferable to store the raw material that meets the higher specs. rather than sell it all off as tech. grade, because the next load that comes in might not meet the requirements for certs. and thus would need to go through a purification process.
What's sad about this story is that because of the regulatory/liability state, it is impossible to engage in simple acts of innovation ("winging it") that could solve problems such as this "shortage." E.g.:
Find a chemical company with some barrels of bicarb. that has been tested to one of the specs., or USP if possible. If they don't have the USP, then have them test the ACS or FCC to the USP std., which would probably pass if it already met one of the other stds.
Then just procure the damn stuff!
If additional sterilization is needed, have the truck routed to an accessible sterilization service. Ie., a facility with a gamma ray sterilization unit, where the material could simply be put on a belt and sent through the rays.
Hospitals should have the capability to filter small lots of solution to further remove any particulates if necessary.
But no, we'd rather incur large risks of an actual death to a patient to stave off some tiny risk.
What a pathetic thing we have become.
That system exists, and it's why medical billing is a speciality in and of itself. It's called the ICD-10, and has been around for decades. The pushback is because the latest revision, which went into effect two years ago, is hyper-specific to the point of absurdity.
Pecked by a chicken? There's a code for that: W61.33. But don't you dare get that confused with getting pecked by a turkey or bitten by a duck, which are W61.43 and W61.61 respectively. Don't like your in-laws? That's Z63.1. Injured? It's very important for proper diagnosis to know if you were at the library at the time (Y92.241) or at the opera (Y92.253). Shredding it on water so awesomely that your skis catch on fire? Not only is there a code for that, there are three sub-codes to describe the diagnosis in greater detail. I am not making this up.. You know all those Imperials who died when those two Star Destroyers collided in Rogue one? That's V95.43. And it only gets more wacky from there.
Now do you see why there's been some pushback?
Imagine all the people...
This is the smoking gun, people. The fact that the situation is constrained by secret agreements between players shows that no free market existed.
The "free market" is a myth, and it has always been a myth. Without some independent mechanism to enforce honest behavior any market will become a criminal extortion enterprise. That is why there are laws against raising prices in emergencies. Otherwise bottled water and cans of food would go up by double digit amounts in case of a hurricane, tornado or earthquake, and people might even die as a result.
Of course these days it doesn't take a catastrophe for greedy corporations to charge obscene prices. Epi-Pen, Valeant Pharmaceuticals, and Turing Pharmaceuticals have all engaged in extortion pricing after acquiring existing drugs. This is life threatening and gouges the taxpayer as well.
The history of food and drug regulation in the US is the history of mass poisoning as a result of ignorance, greed and lack of regulation. All the comments about the "ebil gobment" blocking noble free enterprise are right wing masturbatory fantasies.
The biggest issue we face is regulatory capture where special interests take over the government agencies that are supposed to keep them in check. Examples are the revolving door between the FDA and the pharmaceutical industry or the end of Net Neutrality at the hands of the telecommunication cartel.
It's not about the government squashing the free market, it's about corrupt powerful monopolies using the government to enforce their dictatorial control over the economy.
Why is Snark Required?