The recent study by Kluckow and his colleagues points out another serious issue in neonatology: drug shortages. In recent times we have had poor or no supplies of dramatically important drugs, including for example indomethacin, phenobarbitone and more recently caffeine. We also had a shortage of betamethasone, another life-saving drug, given to mothers threatening preterm labour.
These are drugs that save lives, (and brain cells) and we should not tolerate a situation where cheap generic drugs are difficult or impossible to source for our patients. This occurs largely because they are cheap and generic, so there are very limited profits to be made. When statins are potentially given to a billion people and Lipitor alone has made 120 billion dollars in sales, how can we convince a company to continue to make a drug which is administered to a very small population of very small people, who consequently don’t pay very much for the tiny quantities that they use?
I think the answer is a government drug production agency, who can control and manufacture the drugs that we need, according to proven benefit, rather than profit margins. I can’t see another way to assure the continued availability of essential drugs, unless we as a collective decide to make it a priority.