A gray market of secondary pharmaceutical suppliers is driving up the price of lifesaving drugs that are in short supply, with markups ranging from 100% to more than 4,500%.
On average, drugs are being marked up 650% on the gray market, according to Premier Healthcare Alliance, which analyzed 636 unsolicited sales offers received by acute care facilities in its network. Ahe drugs were either back-ordered or unavailable through the manufacturer. The top 10 highest markups, seen in cardiology, sedation, critical care, and oncology drugs, were more than 1,000% over base contract prices:. labetalol (4,533%); cytarabine (3,980%); dexamethasone 4- mg injection (3,857%); leucovorin (3,170%); propofol (3,161%); papaverine (2,979%); protamine sulfate (2,752%); [levophed (2,642%); [sodium chloride concentrate (2,350%); and [furosemide injection (1,721%).
Gray market vendors generally advertise drugs through e-mails and faxes that tout the shortage of the products, Premier officials said, with language such as “we only have 20 [units] of this drug left and quantities are going fast.”
The reported price gouging comes as the country faces an unprecedented shortage of drugs. By the end of 2011, there could be more than 360 drugs in short supply, according to projections by Premier.
Hospitals and pharmacies must beware when purchasing drugs on the gray market, not just because of the inflated price, but also because of safety risks, Premier officials warned. Products sold on the gray market may have been mishandled, rendering them ineffective or harmful; they also could be counterfeit or diluted.
Stolen, counterfeit, and mishandled drugs are also difficult to recognize. Even the original manufacturers may not be able to spot fake drugs, according to analysts for Premier. And hospitals that try to avoid gray market vendors may encounter problems because these vendors have sophisticated methods of impersonating legitimate, licensed distributors, according to Premier.
Drug shortages are also getting increased attention in Washington, where a bipartisan group of senators has been urging the Food and Drug Administration to do more to address these shortages. The FDA will hold a public meeting on the issue on Sept. 26.