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The Gray Market

How prescription-drug shortages are emptying pockets and threatening your health

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By now, most of us are aware that our health care system has been compromised yet again.

This time it’s a crisis born of a seemingly never-ending number of unexplained drug shortages. We have heard the horror stories and seen the faces of children suffering from leukemia and other forms of cancer, who aren’t getting the medications that could save their lives or at least ease their pain. We’ve been made aware of breast cancer victims postponing necessary treatments for lack of a certain drug. And then there are the heart attacks; people are dying from something that could and should have never happened if only the inexpensive, preventive medicines had been available. As with all tragedies resulting from some human shortcoming such as incompetence, greed or the longing for power, we need, even demand, someone to blame, but who?

Thanks to the world’s largest drug manufacturers, our elected officials and a media environment addicted to good visuals and easy answers, we have been given a culprit in recent weeks: a dastardly collection of small medical distribution companies collectively referred to as the “gray market.” These companies make their profits in the secretive shadows of the mainstream pharmaceutical sector.

Even though the gray market has actually been around for decades, its participants are becoming far more active and visible as the shortage crisis worsens. As a result, they are being offered up for slaughter by nearly every politician these days, from President Barack Obama on down. And why not? Low-hanging fruit is a staple on the political food pyramid, and these gray-market distributors are easy to digest. They’re an electioneering gift like Willie Horton, something you can kick hard and be assured that everyone will applaud. And no one is arguing that these pharmaceutical shadow-dwellers don’t do unsavory things.

For instance, if you can’t find a particular medication that’s in short supply, and you absolutely need it to keep your child or partner or mom or dad alive, the gray market is where your health care provider will likely turn when all else fails. And chances are these opportunistic distributors can get you what you need. The catch is that on the gray market, the drug may cost hundreds of times its original price. It may be mislabeled, counterfeit or no longer safe to put in your body from having been stored or transported improperly. In fact, the only thing you can count on for sure from the gray-market suppliers is that the drug will ultimately find its way to the highest bidder willing to take a chance on their products.

But paying more can’t always solve the problem. When he last checked the status of generic cancer drugs available in August of this year, Dr. Ezekiel J. Emanuel, chairman of the department of medical ethics and health policy at the University of Pennsylvania and head of the Department of Bioethics at the Clinical Center of the National Institutes of Health, found that 14 of the 34 drugs were in short supply. Some of the 14 unavailable drugs are necessary for the treatments to cure leukemia, testicular cancer and lymphoma. It is no wonder that, when faced with such diseases and no drugs to treat them, people will at least attempt to find them on the gray market.

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