Shortage of medications to come?

[Miss Prim]

Hi all.  I am having trouble getting one of my blood pressure medications.  I called in to the pharmacy last Wed., went to pick up on Saturday and they said they didn't have any and would be getting a shipment on Monday.  Went on Tues and they said they were all out!  I got them to give me 3 pills as I was totally out as of that day.  They said they would be getting a shipment yesterday after 5, so I will try again today.  I'm really starting to think that we may be headed for a big problem!  I know a lot of the generic medication is made in China and we know how hard hit they were with the virus and having to quarantine.  Any one else having a problem getting meds?

                                                                         Miss Prim

[rantk81]

I am due to refill 2 scripts today!  Hopefully I don't have any problems! I'll let you know.

[BikeFanatic]

I heard there was a shortage of hydroxychlorquine, due to the virus, lucky I just refilled before the lockdown. Peutorico also makes a lot of meds. Can you try another pharmacy, BP meds are so important.

[Bourbon]

Yikes!  Maybe try another location if possible?  We've had issues in normal ties filling scripts for our son, usually just not on hand and have to wait 5 days but driving to another Kroger gets it faster .

[wenchsenior]

I was also worried about this when I discovered my bcp pack was four days from empty, and I didn't realize I had no others in the house.   But the pharmacy filled it the next day.  Pretty relieved, but worried about my husband and mother, who both have regular Rxs for other stuff...

[rantk81]

Just picked up 90 day supplies of a generic blood pressure medicine and generic statin from CVS pharmacy inside of a Target, no issues at all.

[hops]

Our mail-order pharmacy is warning of (understandable) delays and our nearest retail pharmacies are cutting their hours. It recently took about a week longer than usual to obtain a basic stomach medication. I expect problems with my next hydroxychloroquine refill but have enough to last the next three months.

Refilling as early as possible, and getting the largest quantity of meds you can afford, is very important. If you can save time by bypassing insurance and paying out-of-pocket (some meds cost much less than you'd imagine), it's something to strongly consider.

Your doctor's office might also be able to help with samples, even for very pricey medications. If you're part of a manufacturer's support program, they should have hotlines that can help if you're about to miss something important, like a biologic dose.

[SunnyDays]

This might play out like the toilet paper shortage if everyone refills as many pills as they can get.  In Canada, we are now limited to 30 days at a time, which means more trips to the pharmacy and more potential virus exposure, but at least meds will last longer.  As long as the manufacturers remain at normal capacity anyway.

[Cassie]

Taking ace inhibitors for blood pressure is dangerous with the virus. I checked mine to make sure they didn’t fall into this category.

[hops]

This might play out like the toilet paper shortage if everyone refills as many pills as they can get.  In Canada, we are now limited to 30 days at a time, which means more trips to the pharmacy and more potential virus exposure, but at least meds will last longer.  As long as the manufacturers remain at normal capacity anyway.

I've been waiting to see if any of my specialists start encouraging 30-day supplies instead of 90-day, but so far it's not happening. My gastroenterologist is even changing Humira prescriptions from 28-day supplies to 56 when insurance allows.

Medication hoarding in times of panic is obviously not advisable, but when life -- and supply chains -- are "normal" it's imperative to be as well-stocked as possible as part of a general emergency preparedness plan.

[rantk81]

How does one "hoard" prescription medicine anyway?  Doesn't the insurance company and/or pharmacy pretty much always enforce time constraints on how fast you can re-fill?

[chemistk]

How does one "hoard" prescription medicine anyway?  Doesn't the insurance company and/or pharmacy pretty much always enforce time constraints on how fast you can re-fill?

My employer plan usually only allows 30 day refills, but they recently authorized 90 day refills on any medication temporarily, so if a few big companies do this, it's entirely possible for the panicky to go out and take full advantage.

[Gin1984]

Also think what will happen if manufacturing for both human and animal medication cannot be done because too many people are ill.

[Scotland2016]

I can attempt to refill my prescription of hydroxychloroquine on Friday. I'm nervous I won't be able to get it. Also, I get a 90-day supply from a mail order company in another state. Our governor recently limited prescriptions of hydroxychloroquine to a 30-day supply, so not sure how that will play out.

[chaskavitch]

I am a microbiologist at a company that manufactures generic pharmaceutical products (derms and creams mostly).  We're considered a vital business and are continuing manufacturing during our state shutdown.  They even gave us an "official" letter to carry in case we're stopped on the way to or from work.

However, we're also telling people with ANY symptoms to stay home (without charging them PTO or sick leave, thankfully), and they're moving schedules and shifts around to keep the manufacturing floor as spaced out as possible.  We've definitely slowed down the pace of product out the door, because it's much slower to manufacture and package product when everyone is trying to stay 6 feet apart, and people are staying home sick or watching their kids.  Medication, even OTC meds, will still be made, but might be in slightly shorter supply.

[M2 pilot]

Not sure, but I think that a most of our drugs and their precursors come from China. FDA inspectors go to China to examine and approve of the manufacturing facilities. FDA inspectors can not be made to go to China to make these inspections.  How many do you think will volunteer to go there?
This could make things interesting.

[lost_in_the_endless_aisle]

Taking ace inhibitors for blood pressure is dangerous with the virus. I checked mine to make sure they didn’t fall into this category.

According to this the case for that assertion is not so clear.

[Hotstreak]

Taking ace inhibitors for blood pressure is dangerous with the virus. I checked mine to make sure they didn’t fall into this category.

According to this the case for that assertion is not so clear.

Doctors are reporting publicly that certain BP medications interfere with the virus's ability to enter the host.  The idea that these BP meds increase risk was preliminary, and shown to be wrong.

[rantk81]

Taking ace inhibitors for blood pressure is dangerous with the virus. I checked mine to make sure they didn’t fall into this category.

According to this the case for that assertion is not so clear.

Doctors are reporting publicly that certain BP medications interfere with the virus's ability to enter the host.  The idea that these BP meds increase risk was preliminary, and shown to be wrong.

Got a source/link? As someone who takes a BP med, I'd be interested to read about it!

[rantk81]

How does one "hoard" prescription medicine anyway?  Doesn't the insurance company and/or pharmacy pretty much always enforce time constraints on how fast you can re-fill?

My employer plan usually only allows 30 day refills, but they recently authorized 90 day refills on any medication temporarily, so if a few big companies do this, it's entirely possible for the panicky to go out and take full advantage.

Weird!  My employer's medical plan *requires* us to do 90-day fills for on-going maintenance drugs, due to the lower cost in bulk I suppose!

[Abe]

There is no good indication one way or other that ACE inhibitors or ARBs decrease the severity of coronavirus infections. There was some anecdotal reports from SARS and MERS, along with cell cultures, but that doesn't mean anything for now. Clinical trials are underway, but a prior randomized trial for ARDS (unrelated to coronavirus, was done in 2017) showed no benefit to upregulating that pathway and was terminated early (https://www.ncbi.nlm.nih.gov/pubmed/28877748). Current recommendations: continue as prescribed. Definitely don't start these if you don't take them already.

Also, people need to stop hoarding inhalers. They don't help with the coronavirus infection, and us asthmatics need them. Local pharmacies here were out of albuterol.

[Miss Prim]

I finally got my blood pressure medication in the nick of time a few days ago.  Thank goodness it is for 3 months so I won't have to worry about it for awhile.  I hope this was just an anomaly and not indicative of what is to come!

[thesis]

I went to the grocery store the other day and was shocked to find a decent amount of toilet paper. I think after people have finished hoarding in fear, it seems the supplies of many things are returning to normal. This will probably be the same for prescriptions, unless your prescription happens to be a drug that is being experimentally used to treat covid-19. Otherwise, there might be a slight disruption, but it will very likely be temporary.

[partgypsy]

No problem refilling prescriptions, which come as 3 month supply. Otoh no toliet paper still in the couple stores I shop in. I did order a couple month supply from Amazon before everything hit, so I have at least a months supply. I usually get my tp from Amazon. Ironically may need to end up buying in store if this continues.

[soccerluvof4]

I was watching an interview of the CEO of CVS just last week and he said the supply chain is strong that they have a minimum of 3 months but closer to 6 months of supply on hand and this was justified when I asked a friend of mine that owns a Pharmaceutical company my son works at that supplies most of the nursing homes with all there Meds. Like alot of things right now the supply chains are more the issue so one would hope there addressing that now and in the future alot of these drugs will be returned to the USA to be manufactured.

[AnnaGrowsAMustache]

Yes. Stock up if you can. Even things like over the counter pain medicine could get very scarce.

[scottish]

Fortunately your orange president is only promoting plaquenil (hydroxy-chloroquine) so far.     

More good news - he says he's going to take it himself.    After a couple of days of plaquenil he will feel so sick that he will reverse course and tell everyone that it's a horrible drug, much worse than actually getting covid-19.    Terrible, terrible stuff.    There's no way it could treat covid-19.

Especially if he tries the Chinese recommendation of 1000 mg/day.

[lost_in_the_endless_aisle]

Fortunately your orange president is only promoting plaquenil (hydroxy-chloroquine) so far.     

More good news - he says he's going to take it himself.    After a couple of days of plaquenil he will feel so sick that he will reverse course and tell everyone that it's a horrible drug, much worse than actually getting covid-19.    Terrible, terrible stuff.    There's no way it could treat covid-19.

Especially if he tries the Chinese recommendation of 1000 mg/day.

If there's no way it could work, better make a few phone calls and save some people some trouble; also, the US studies are not using 1000mg/day:

hydroxychloroquine 400 mg po bid loading dose for 1 day followed by 200 mg po twice daily for 4 days

tablet hydroxychloroquine (HCQ). Day-1 (initial) 1st dose, 3 tablets (200 mg per tablet), 2nd dose after 6 hours, 3 tablets (200 mg per tablet) per oral. From day 2 to 7 (maintenance dose), 2 tablets twice a day

South Korea is using once daily 400mg doses iirc. Also I thought the Chinese study was 1000mg of chloroquine phosphate rather than hydroxychloroquine. Here is brief JAMA podcast on HCQ (it's possible to talk about this as a potential therapeutic without suffering from TDS).

[AnnaGrowsAMustache]

Fortunately your orange president is only promoting plaquenil (hydroxy-chloroquine) so far.     

More good news - he says he's going to take it himself.    After a couple of days of plaquenil he will feel so sick that he will reverse course and tell everyone that it's a horrible drug, much worse than actually getting covid-19.    Terrible, terrible stuff.    There's no way it could treat covid-19.

Especially if he tries the Chinese recommendation of 1000 mg/day.

It also has some great side effects. He hasn't mentioned those.

[bacchi]

Fortunately your orange president is only promoting plaquenil (hydroxy-chloroquine) so far.     

More good news - he says he's going to take it himself.    After a couple of days of plaquenil he will feel so sick that he will reverse course and tell everyone that it's a horrible drug, much worse than actually getting covid-19.    Terrible, terrible stuff.    There's no way it could treat covid-19.

Especially if he tries the Chinese recommendation of 1000 mg/day.

If there's no way it could work, better make a few phone calls and save some people some trouble; also, the US studies are not using 1000mg/day:

hydroxychloroquine 400 mg po bid loading dose for 1 day followed by 200 mg po twice daily for 4 days

tablet hydroxychloroquine (HCQ). Day-1 (initial) 1st dose, 3 tablets (200 mg per tablet), 2nd dose after 6 hours, 3 tablets (200 mg per tablet) per oral. From day 2 to 7 (maintenance dose), 2 tablets twice a day

South Korea is using once daily 400mg doses iirc. Also I thought the Chinese study was 1000mg of chloroquine phosphate rather than hydroxychloroquine. Here is brief JAMA podcast on HCQ (it's possible to talk about this as a potential therapeutic without suffering from TDS).

This Chinese study, with a small sample size, found hydroxychloroquine didn't make any difference.

http://subject.med.wanfangdata.com.cn/UpLoad/Files/202003/43f8625d4dc74e42bbcf24795de1c77c.pdf

Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only.

The results are in english on page 2.