We Who Are About to Die Salute You: America and Drug Shortages

https://i2.wp.com/b01.deliver.odai.yale.edu/b3/f0/b3f0f1fb-87ee-4827-b6f7-cd3b7531e3bc/ag-obj-9187-001-pub-med.jpg
Jean-Léon Gérôme, Ave Caesar! Morituri te salutan, 1859

Right now America is experiencing yet another drug shortage. This time it is Benadryl, a life-saving antihistamine. The good news is that it is only a certain formulation of Benadryl, the type injected or delivered through an IV, that is nearly gone. The bubblegum-flavored nastiness you may remember from childhood seems likely to remain on drugstore shelves for some time yet. The bad news is that the people who need IV Benadryl are the sickest and most likely to suffer or die from these shortages.


Ave Caesar! Morituri te salutant.

Hail to the keepers of life-saving drugs, we salute you as the prisoners of old did the Caesar. We prepare to fight through yet another drug shortage. This is not the first time we have gone to war, but this may be the battle from which we do not return.

We, condemned to die for the crime of being chronically ill or suffering from allergies, plead for our lives before launching ourselves into another risky day. We will once again desperately cry out to the powers that be. We have been told “in few weeks,” “next week,” “certainly by next month” — as our own hourglass has run out. The Caesars of the drug world have declared there to be manufacturing delays. Some companies now tell us it will be 2019 or 2020 before product is shipping normally again.

I am watching the threads of the warriors around me grow thin. We will be cut short because of the poor planning and the unresponsiveness of the drug manufacturing world. First it was epinephrine, then fludrocortisone, and now diphenhydramine. The list goes on and on.

We will go down fighting. We will roar into the void as the audience looks on appreciatively. For the Caesar, it is a mock battle. For those who need Benadryl for an emergency, before procedures to limit reactions, or are on continuous Benadryl therapy to survive their conditions — as is the case for some with mast cell disease — the battle is horrifically real. I have read some online boards claiming that IM and IV Benadryl is really of no great significance, as epi is the first line for anaphylaxis and other meds can be given by mouth or feeding tube later. Let me assure you that for those with mast cell disease who rely on continuous IV Benadryl to live, this shortage is very significant indeed. Without adequate supplies, in about a week lives will be forfeit to the games and strategies of Mylan, Pfizer, Hospira, Westward, and Fresenius Kabi.

For those at risk of losing this battle, The Mastocytosis Society is attempting to get the sickest patients help. Visit https://www.mastattack.org/2018/11/for-patients-affected-by-the-iv-benadryl-shortage/ for more information.

To everyone else, especially the committees in charge of drug shortages: We who are about to die salute you.

 

 

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