E-drug: Re: Wall Street Journal on expired drug (cont'd)
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Wall Street Journal on expired drugs (donations)
The military authorities are fooling themselves (and us).
Military authorities are "saving" large amounts of money by prolonging
expiry dates on drugs. But I believe they are fooling themselves and us.
War is a catastrophy, and drugs for catastrophy use have to be extremely
ready-to-use. A certificate of prolonged shelf-life for a drug has no value
in a war situation. Such information has to be on site in the situation of
use. That means that every single package has to be relabeled with the new
expiry date. Not only every package, but every innermost package or
container, since cartons usually are thrown away when opening a drug
package.
I very strongly suspect that relabeling is not included in the calculation
of sings for expiry date prolonging. And as a consequence of that, I
believe that military authorities have not yet thought of the worthlessness
of wronglabeled emergency drugs.
We have had some "small" wars in the past few years, and some learning from
that. One such piece of information seems to be that soldiers will not like
to receive out-of-date solutions for intravenous infusion "because it would
be politically sensitive if G.I. Joe was lying in bed and saw it had
originally expired three years ago." I suspect that this applies to other
drugs as well, so the outdated medicines may almost be the same as dead
cargo, or even worse
It was in the old days that everlasting was the ideal. Even if a T-Ford is
still driveable, it is not very useful nowadays. For drugs, it is the
usefulness in the situation that counts. Emergency drugs, even though they
usually are generics and off patent, are still tools demanding special
knowledge, usually not on site. We are back to the question of good
labeling.
Drugs are multicomponent products where the active ingredient is only one
of the components. Other components that can expire are excipients (usually
at least 5 different), packaging materials, and information (labeling). In
fact it is very strongly in our interest that the first thing to expire is
the expiry date.
In emergencies resources are limited. Pouring out-of-date (or close to)
medicines into a disaster area is a waste of resources, regardless of the
disaster being war, post-war, earthquake or flooding.
Stein Lyftingsmo
Hospital Pharmacy of Elverum
N-2418 Elverum, Norway
phone +47-6243 8950
sjappe@apotek.no
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