The sharp rise in out-of-pocket healthcare spending

https://drugstorenewsce.com/content/sharp-rise-out-pocket-healthcare-spending

ANN ARBOR, Mich. — Even if you have what you might think of as good health insurance, your next hospital stay could cost you more than $1,000 out of your own pocket.

And that amount has gone up sharply in recent years — a rise of more than 37% just for straightforward hospital stays for common conditions.

Those striking statistics come from the first published analysis of actual out-of-pocket spending by people with private health insurance, most of it provided by employers. It’s appearing today in the JAMA Internal Medicine, and being presented at the AcademyHealth Annual Research Meeting in Boston.

To see the rise in costs paid by privately insured hospital patients, researchers at the University of Michigan’s Institute for Healthcare Policy and Innovation looked at data from more than 50 million Americans in a four-year period.

All of them had insurance plans offered by the four major companies that pool their data via the Health Care Cost Institute, of which IHPI is an academic partner.

The biggest change in out-of-pocket spending came from two types of insurance plan charges: one that patients are familiar with, and the other that is not so familiar.

Deductibles — the amount that patients pay for their care before their insurance kicks in — rose by 86%. Co-insurance — a percentage of the cost of the hospital stay that insurance plans often expect patients to pay, but patients may not even realize they will owe — rose 33%.

“These results open up the ‘black box’ of health care, and show all the costs of hospitalization that are billed to people with private insurance. For many, these may appear to be ‘hidden costs’ that they didn’t realize they would owe,” says first author Emily Adrion, PhD, MSc, a U-M research fellow with the Center for Healthcare Outcomes and Policy. “It shows that even people with the most comprehensive insurance are paying thousands of dollars, at a time when they need hospital care and may not have time to shop around.”

She and her colleagues, including senior author Brahmajee Nallamothu, MD, MPH, note that the growth in out-of-pocket costs was 6.5% a year, compared to a 5.1% growth in health insurance premiums, and a 2.9% growth in overall healthcare spending.

The study looked at costs billed to people between the ages of 18 and 64, from 2009 to 2013. In addition to a broad-based analysis, the researchers took a closer look at those who had heart attacks, pneumonia, appendicitis, heart bypasses, total knee replacement or spinal fusion procedures, and women who gave birth.

It’s different from other studies that have estimated out-of-pocket spending based on the design of insurance plans.

The percentage of patients who were charged deductibles and co-insurance rose by more than five percentage points during the study period.

Co-payments, which are different from co-insurance and are a kind of “entry fee” to a hospitalization, actually fell during this time. But this was due to the fact that fewer insurance plans charged a co-pay for a hospital stay in 2013 than had charged one in 2009 — not to an actual drop in the dollar amount of the co-pays charged to patients who owed one.

The study also reveals sharp differences in out-of-pocket costs for people who chose “consumer-directed” health plans offered by their employers — which often take the smallest bite out of each paycheck — and for people who bought individual private plans during the study period.

For those with consumer-directed plans, the total they’d owe after a straightforward hospital stay topped $1,200 on average. Their employer may have also offered them a way to save pre-tax dollars in a special account to help pay for that, but the study data don’t show that information.

For those with individual private plans, the bite was even harsher: $1,800 on average. Adrion notes that to qualify for an individual private plan during the study period, patients would have to have met standards for good health. A provision mandating that plans cover all adults regardless of pre-existing conditions didn’t take effect until 2014.

“These results show the importance of reading the fine print when you choose a health insurance plan, and being prepared to spend more out of your own pocket after a hospitalization than you might have expected,” says Nallamothu, a professor of internal medicine at U-M and IHPI member.

Patients can also make sure they understand which hospitals and doctors are “in network” for their plan, which might mean lower co-insurance costs. And, for people who can’t pay their entire bill at once, or at all, it means talking to the hospital about a payment plan or even a write-off of some costs under their charity care policy.

The study period didn’t include private individual and family plans bought on the exchanges set up under the Affordable Care Act. Those plans began covering people in January 2014 and are open to anyone regardless of their health status. The study period did include the first years when the ACA mandated that adults up to age 26 could remain on their parents’ private health plans.

Recent estimates by the Kaiser Family Foundation suggest that the trend seen in these data has continued. According to a recent KFF report, 81% of people who get insurance through an employer have an annual deductible of about $1,300, and more than two-thirds of them also have co-insurance as part of their coverage. An even greater percentage of people who bought “silver” plans on an ACA exchange also have co-insurance provisions in their plans.

But plans bought on the ACA exchanges (including healthcare.gov) come with a federal cap on out-of-pocket spending of $6,800. Plans provided by employers, or bought individually outside the exchanges, don’t have such a cap. Adrion and her colleagues plan to study future HCCI data to look at spending trends.

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Supreme Court right to not interfere with Wash. state’s pharmacy contraceptive rules

http://www.seattletimes.com/opinion/editorials/supreme-court-right-to-not-interfere-with-wash-states-pharmacy-contraceptive-rules/

I wonder if Judge Susan Graber‘s opinion “Speed is particularly important considering the time-sensitive nature of emergency contraception and of

many other medications…

The personal beliefs of pharmacists cannot outweigh their professional duty — or the law.”

could apply to medications that are used for subjective diseases (pain, anxiety, depression, ADD/ADHD, mental health) that the pt should not be subjected cannot send the woman to another pharmacy miles away… which seems to describe the “Pharmacy crawl “

Does this open a “can of worms” for those Pharmacists who believe that they can reject filling a otherwise legal Rx … for any reason ?

The U.S. Supreme Court was right not to interfere with Washington’s rules regarding a woman’s access to emergency contraception at the pharmacy.

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DEA Source Confirms that Schedule II Marijuana is in the Works.

http://www.smobserved.com/story/2016/07/04/news/dea-source-confirms-that-schedule-ii-marijuana-is-in-the-works/1562.html

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Senators face off over bill to help retired coal miners

http://www.whas11.com/ext/news/nation-now/senators-face-off-over-bill-to-help-retired-coal-miners/417/nationnow/5NiKd4r2g0yCgKK8oQGKeC

 

 

While McConnell is not up for election until 2020… there are more Republican Senators up for re-election than Democrats… At the very least McConnell could be stripped of his Senate Majority Leader status.  Hillary Clinton has stated that – if elected – she is going to put coal miner out of  a job and close coal mines..  Apparently the Republicans just want to play games with their health insurance and let them suffer and die – or commit suicide – sooner than they would otherwise.

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Father of woman who died in Douglas County Jail suing for $1.35 million

http://www2.ljworld.com/news/2016/jul/03/father-woman-who-died-douglas-county-jail-suing-13/

Heading into the Douglas County Jail, Rachel Hammers understood that alcoholism put her health at risk.

In particular, Hammers, 32, was afraid that her jail sentence for drunken driving would send her into a fit of seizures induced by alcohol withdrawal, so she sought medical attention, according to a federal lawsuit filed in Kansas City, Kan.

A doctor prescribed medication for Hammers that would lessen the alcohol-withdrawal effects, and her medical records were faxed over to the jail prior to her incarceration, the lawsuit says.

The evening of May 11, 2012, after Hammers was booked into jail she called her family and told them she would be in touch the next day so she could speak with her daughter, the lawsuit says. Here are the Top 100 Criminal Defense Lawyers from SoCal Law Network that you should read about and understand the kind of legal help you need.

The next morning guards found Hammers unresponsive and bloodied in her cell. She was taken by ambulance to Lawrence Memorial Hospital, where she was pronounced dead just under an hour later.

Now, Hammers’ father, Joe Harvey, who is an oral surgeon in Lawrence, is suing Douglas County officials, employees and medical staff under contract at the jail, alleging that his daughter died needlessly and in pain.

Harvey’s lawsuit is seeking $1.35 million from the county to compensate for pain and suffering caused by his daughter’s death. Douglas County officials declined to comment for this article. But through court filings, the county has denied allegations of wrong-doing.

Harvey also declined to comment specifically on the lawsuit, saying only: “My family and I have great faith in our legal team.”

An early widow

By her early 30s, Rachel Hammers was a widow and a mother to three daughters and a son. Hammers married Sean Hammers in April 2010, but he died just 19 months later.

Hammers was one of eight children born to Harvey and his wife, Mary Hansen Harvey. She was a graduate of both Perry-Lecompton High School and Kansas University.

The lawsuit acknowledges that Hammers had a history of alcohol abuse and depression, but she had no criminal history prior to 2011, Douglas County District Court records show.

But in late 2011, that would change. Court records show that in 2011, Hammers had two drunken driving offenses, and parole violations related to those offenses which led to her incarceration in the Douglas County Jail on multiple occasions.

Harvey’s lawsuit alleges that jail officials should have known that Harvey’s serious alcohol abuse — she told doctors she often drank a liter of rum per day — put her at risk of serious injury if she didn’t receive the proper medication to reduce withdrawal symptoms.

Lawsuit filed

Harvey’s civil suit was filed in federal court in Kansas City, Kan. in April 2015, but it has gained new vigor in recent weeks as Harvey hired new lead counsel for the case, prominent Kansas City Attorney Arthur Benson.

The lawsuit lists as defendants the Douglas County Commission, Douglas County Sheriff Ken McGovern, then-Undersheriff Kenneth Massey, then-Undersheriff Steve Hornberger, Dr. Dennis Sale, the Douglas County Visiting Nurses Association, and three anonymous men who are alleged to have been involved in Hammer’s wrongful death.

Her father’s lawsuit argues that the oversights and failures leading to Hammers’ death were so egregious that they constitute a violation of her civil rights under the Fifth, Eighth, Ninth and 14th Amendments. These rights generally guarantee due process, protection from cruel and unusual punishment, basic human rights and equal protection under the law.

Although a direct cause of death could not be determined, Hammers’ autopsy report concluded that the best explanation was linked to “seizure activity.” She tested negative for both alcohol and drugs when the autopsy was performed.

The lawsuit states that policies and procedures established and enforced within the jail led staff to overlook Hammers’ medical records, put her welfare in the hands of unqualified employees and allowed for a delay in providing emergency medical care.

In total, the lawsuit claims six points where the defendants are at fault, including:

• Deliberate indifference to serious medical need and failure to provide access to medical personnel for evaluation and treatment.

• Failure to train/ Inadequate training.

• Failure to supervise/ Inadequate supervision.

• Wrongful death.

• Negligence.

• Breach of duty to third party beneficiary.

Backstory and timeline

The following is a brief timeline of Hammers’ last months, as outlined in the lawsuit and in Douglas County District Court records:

In October 2011, Hammers was arrested for her second drunken driving offense. Her first offense was five months earlier.

In February 2012, Hammers pleaded guilty to both drunken driving charges, and the next month she was sentenced to serve four days in jail. That sentence was to be followed by a year of parole in lieu of six months of incarceration.

Hammers’ four-day jail sentence was scheduled to begin on March 21, 2012, the lawsuit says. Weary of the impending symptoms of alcohol withdrawal as she served her sentence, she visited a doctor and received a drug prescription to alleviate any potential issues.

The doctor also forwarded Hammers’ medical history and prescribed drug regimen to jail staff, the lawsuit says.

As inmates are booked into the Douglas County Jail they go through a health screening process, Douglas County Sheriff’s Office Sgt. Kristen Dymacek wrote in an email.

“They are asked a series of medical and mental health questions as well as visually observed by corrections officers or deputies,” she said in response to questions from the Journal-World.

During the jail’s screening process, the booking officer indicated that Hammers did not have a health risk, the lawsuit says.

Over the next four days in jail, Hammers experienced moderate and eventually severe withdrawal. On the third day she was sweating heavily and was delusional and hallucinating.

While in jail, inmates experiencing medical issues can alert jail staff, Dymacek said. The staff will then decide what steps to take.

“Corrections officers and deputies are not trained to give medical examinations. They are trained in first aid and CPR,” she said. “Any inmate can alert (jail) staff of a medical need at any point and the appropriate measures are taken to take care of their medical needs.”

Despite her symptoms and medical history, the lawsuit says, the nursing staff neither alerted a doctor nor monitored Hammers more closely; nor did staff adhere to her drug treatment prescribed for alcohol withdrawal.

Hammers was released from jail on March 27, 2012, after serving her four-day sentence. However, she violated the terms of her parole and two warrants were issued for her arrest the next month.

On April 19, 2012, Hammers checked herself into Lawrence Memorial Hospital for alcohol intoxication, depression and suicidal thoughts, once more reporting a history of seizures due to alcohol withdrawal.

Three days later, Hammers was booked back into jail. Once again the booking officer indicated she did not have a health risk. She was released from the facility eight days later.

Once again, Hammers failed to meet the terms of her parole and another arrest warrant was issued. She was booked into jail for the last time on May 11, 2012.

During her third and final medical screening Hammers reported daily alcohol use, hypertension and depression. Again she was determined to have no health risk.

That night Hammers spoke with her family from the jail and said she would be calling the next morning to speak with her daughter. However, the call was never made.

On Saturday, May 12, 2012, at 9:50 a.m., jail staff discovered Hammers in her cell, unresponsive and bloodied, the lawsuit says. “She had no pulse and she wasn’t breathing.”

Jail staff did not perform CPR on Hammers and insisted on waiting for nursing staff to arrive on the scene, the lawsuit says.

In addition, responding nurses did not immediately bring a defibrillator with them to try and resuscitate Hammers. More than five minutes passed before the device was brought to the cell “which diminished the likelihood that she could be successfully resuscitated,” the lawsuit says.

Hammers was taken by ambulance to Lawrence Memorial Hospital, where she was pronounced dead at 10:46 a.m.

More allegations

Many different factors led to Hammers’ death, the lawsuit says, and each factor was exacerbated by failures of all the defendants, individually and collectively, to fulfill their responsibilities.

Inadequate jail policies and procedures regarding both the routine and emergency medical care of inmates “comprise the moving force behind Hammers’ death,” the lawsuit says.

Those policies and procedures were created and enforced by Douglas County officials, employees and medical staff under contract, the lawsuit says.

Several other elements — all stemming from the jail’s policies and procedures — are listed in the lawsuit as factors contributing to Hammers’ death:

• Hammers’ medical history, which was readily available to jail and medical staff, was overlooked and her pre-existing and well-documented conditions were ignored.

• Improperly trained and unqualified jail staff members were entrusted to conduct medical screenings of inmates during the booking process and assess each inmate’s overall health risk.

• Improperly trained and unqualified jail and nursing staff were responsible for determining the severity of each inmate’s medical issues before contacting qualified medical staff.

• Medical staff under contract at the jail were improperly staffed during night and weekend hours.

Each of the factors constitutes a “deliberate indifference” to the medical needs of Hammers and the entire jail population, the lawsuit says. In addition, the collective “actions and omissions” of the defendants ultimately show a “conscious disregard” of civil rights.

Attorneys for Douglas County officials, employees and contracted medical staff all declined to comment on the pending litigation or the specific allegations.

Currently the Douglas County Jail houses 186 inmates and employs 94 staff members “which includes corrections officers, deputies, IT, kitchen staff, maintenance, lobby officers, reentry staff, etc,” Dymacek said.

As a part of an ongoing conversation, the county is considering moving ahead with a $30 million jail expansion, which would add 120 beds to the facility.

The jail, at 3601 North 1360 Road, opened in 1999 and Hammers is the only inmate to have died in the facility, Dymacek said.

Douglas County’s contract with the Visiting Nurses Association and Dr. Sale ended Thursday, said Assistant County Administrator Sarah Plinsky. A contract for the jail’s new medical services provider, Advanced Correctional Healthcare was approved by the Douglas County Commission on June 13, and officially began on Friday.

A jury trial for the lawsuit is scheduled to begin on Oct. 23, 2017, in Kansas Cit

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http://www.opensecrets.org/lobby/

Total Lobbying Spending
1998 $1.45 Billion 1999 $1.44 Billion 2000 $1.57 Billion 2001 $1.63 Billion 2002 $1.83 Billion 2003 $2.06 Billion 2004 $2.19 Billion 2005 $2.44 Billion 2006 $2.63 Billion 2007 $2.87 Billion 2008 $3.30 Billion 2009 $3.50 Billion 2010 $3.52 Billion 2011 $3.33 Billion 2012 $3.31 Billion 2013 $3.24 Billion 2014 $3.25 Billion 2015 $3.22 Billion 2016 $0.82 Billion

Number of Lobbyists*
1998 10,405 1999 12,926 2000 12,541 2001 11,826 2002 12,118 2003 12,919 2004 13,168 2005 14,074 2006 14,482 2007 14,827 2008 14,157 2009 13,751 2010 12,932 2011 12,622 2012 12,185 2013 12,116 2014 11,824 2015 11,520 2016 9,918

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Pharmacies in northern Maine halt sales of certain decongestants to thwart meth labs

https://bangordailynews.com/2016/07/02/news/aroostook/pharmacies-in-northern-maine-halt-sales-of-certain-decongestants-to-thwart-meth-labs/

LINCOLN, Maine — Nearly a dozen northern Maine Rite Aid pharmacies and several independent drug stores are halting nonprescription sales of certain nasal decongestants that contain pseudoephedrine in an effort to stop the illegal production of the street drug methamphetamine, according to pharmacy officials and the health advocacy group that requested the action.

“In the coming days, we are proactively removing non-tamper-resistant, single-ingredient pseudoephedrine products from select Rite Aid stores in northern Maine,” spokeswoman Kristin Kellum of the Camp Hill, Pennsylvania-based retailer, said Tuesday.

Tamper-resistant formulations of pseudoephedrine, such as Nexafed, are designed to block pseudoephedrine from being made into meth and will remain on the shelves.

“As a member of the community and a leading drugstore chain in the state, Rite Aid remains committed to taking appropriate action to help address the methamphetamine problem in northern Maine, while ensuring that we continue to serve patients with legitimate medical needs,” Kellum said.

The products are being pulled from 11 Rite Aid stores in northern Maine, Rite Aid spokeswoman Ashley Flowers said Thursday, declining to provide the locations or the product brand names. Rite Aid has around 4,700 locations nationwide and more than 60 stores in Maine.

“No Bangor stores are included,” she said in an email.

While there will be no behind-the-counter pseudoephedrine at the 11 northern Maine locations, if someone has a prescription, the Rite Aid pharmacists will be able to fill it, Flowers said.

“In Maine, a prescription is not needed to purchase a product containing pseudoephedrine; however, if a physician were to write such a prescription, we would fill it as we do today,” she said.

Aroostook County District Attorney Todd Collins said the change should make a difference because “methamphetamine simply cannot be manufactured without pseudoephedrine.”

Collins visited every pharmacy in Aroostook County last week to call attention to the issue of meth making in small clandestine “labs” and their connection to products like Sudafed that contain pseudoephedrine.

Some other allergy medications, including Allegra-D and Claritin-D, are being pulled as part of the change, a pharmacist from northern Maine who asked not to be identified said.

“We feel that this is a huge step forward in our effort to decrease substance abuse misuse [of the products],” River Coalition executive director and Partnership for a Healthy Northern Penobscot member Linda McGee said Tuesday.

The Save A Life Substance Abuse Task Force, facilitated by the Partnership for Healthy Northern Penobscot, was created in December 2014 and is a group of nearly 50 Lincoln community leaders, residents, physicians, pharmacists, people in recovery, educators and business owners who are meeting to address the region’s drug addiction problem, McGee said.

The group asked Rite Aid, Hannaford and Wal-Mart to stop carrying Sudafed, and Rite Aid was the first to respond. Hannaford has said they are unable to comply at this time, and the group is still waiting to hear from Wal-Mart, McGee said.

“There are a lot of people coming from southern Aroostook County to get Sudafed,” McGee said. “They arrive in carloads. They would get everything they could get and then head back.”

Several independent St. John Valley pharmacies also have reported high rates of southern Aroostook County residents visiting their stores and attempting to purchase Sudafed, and have decided to remove the nasal decongestant.

St. John Valley Pharmacy in Fort Kent, Madawaska Pharmacy, Mars Hill Pharmacy Inc. and Presque Isle Pharmacy are no longer carrying Sudafed.

Dwayne Carr, pharmacist at Presque Isle Pharmacy, said that store stopped selling Sudafed last week at the request of the Maine Drug Enforcement Agency and Aroostook County DA Collins. Carr said people were attempting to purchase the drug “on a daily basis” at Presque Isle Pharmacy.

Maine was one of the first states in the nation to make customers ask for pseudoephedrine, which was moved behind the counter in 2005, produce an identification to purchase it and to restrict how much people could buy to 9 grams per month. In 2013, state legislators strengthened the law by adding an electronic tracking system that prevented people from buying from several locations to get more than their monthly allowance.

The nasal decongestant is used to make “shake and bake” or “one pot” meth using plastic soda bottles that have been found all over the state, with about half discovered in Aroostook County.

“Many people don’t realize that the manufacturing process uses such caustic materials that the resulting concoctions are actually hazardous waste materials and need to be isolated by specialized teams and then destroyed by [Department of Environmental Protection] protocols,” Collins said. “It is an enormously expensive undertaking in addition to the risk of poisoning and explosion and fire that the meth manufacturing process presents.”

The “shake and bake” meth is made by mixing certain common household chemicals together with Sudafed or other drugs containing pseudoephedrine, which is “cooked” by adding lithium taken from batteries, according to Peter Arno, commander of Maine Drug Enforcement Agency division II, which covers the northern half of the state.

He said meth, an illegal stimulant that has plagued western parts of the U.S. since the 1980s, started to creep into Maine about seven years ago.

There was one meth lab bust in Maine during 2009, and the number has since increased every year, with two found in 2011, eight in 2012, 11 in 2013, 37 in 2014 and a record 56 manufacturing and disposal sites found last year.

With 40 meth labs found so far this year in Aroostook County, the area accounts for nearly half of the 85 meth labs found in the state by MDEA agents, according to the tally of clandestine labs kept by the Maine Department of Public Safety.

When methamphetamine hits the streets and rural roads of Maine, it’s called meth, crystal, crystal meth, chalk or ice, and looks like a clear, white or off-white crystal powder. The stimulant, which can be extremely addictive, can be snorted, smoked, dissolved into a beverage or injected.

“Methamphetamine use and production is a significant problem in our community and it needs a community solution,” Collins said. “The simplest, quickest and most effective community response would be to take pseudoephedrine off of the shelves from Houlton to Madawaska.”

BDN writer Anthony Brino and Jessica Potila of the St. John Valley Times/Fiddlehead Focus contributed to this story.

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Epilepsy drug shortage leaves patients desperate

http://www.northbaynipissing.com/news-story/6746529-epilepsy-drug-shortage-leaves-patients-desperate/

TORONTO — Mistie Delorey isn’t sure where to turn next: the Fredericton mother has a dwindling supply of clobazam, a medication that prevents her eight-year-old son from experiencing life-threatening daily seizures — and there’s a critical shortage of the drug across the country.

“I’m terrified, I’m literally terrified,” said Delorey, whose severely autistic and non-verbal son, Cameron, suffers from multiple types of seizures, including the potentially lethal kind.

“The fatal seizures will happen with anybody taken off this drug — immediately. It’s that serious. You can’t be just taken off this drug for even one dose.”

Clobazam, one of two anti-seizure drugs her son takes, has kept Cameron well-regulated over the last four years, dramatically reducing the frequency of episodes to about four a year from roughly 17 a day before he began taking the medication, she said.

But when Delorey went to refill his prescription more than two weeks ago, the pharmacy told her it had none in stock due to a Canada-wide shortage. Other Fredericton drugstores she contacted also couldn’t accommodate her.

“Two of them outright said, ‘We have some, but you’re not getting it,’ because they have patients who require that medicine and they’re saving it for them, which I can understand.”

A third said it would try to help her. But because the pills must be sent to a compounding pharmacy to be made into a liquid — Cameron can only swallow pureed foods and liquids — the drugstore wasn’t able to fulfil her request.

She was finally able to secure four weeks’ supply of the drug from the local hospital, but only with the help of the Canadian Epilepsy Alliance, a network of organizations that advocates for people with seizure disorders and their families.

“It was a huge relief that I secured a month’s worth,” said Delorey, whose supply of clobazam for Cameron is now down to about 2 1/2 weeks.

“And then slowly, hour by hour since that happened, I’m just: What do I do next month?”

Suzanne Nurse, chair of the Canadian Epilepsy Alliance Drug Shortage Committee, said an estimated 20,000 to 40,000 Canadians rely on clobazam to control their seizures and there have been three major shortages in the last three years.

Generic drug manufacturer Apotex provides 70 to 80 per cent of the clobazam sold in Canada, with the rest of the market covered by generic drug maker Teva Canada and Lundbeck Canada, which sells the drug under the brand name Frisium. Pro Doc Ltd. sells a private-label brand in Quebec.

Nurse said there was a disruption in the supply of clobazam made by Apotex last June, which was resolved a month later. But then the company posted a notice in early December that the medicine was again on back-order and the shortage wasn’t expected to be resolved until this month.

“So there’s been many months now where the main supplier of this drug has not been supplying the market,” she said.

“We’re in a situation where there’s a very low supply or depletion of this drug in Canada, and it’s going to take a period of time to get back to regular supply levels where people won’t have any trouble getting the drug.”

Nurse said she’s been contacted by a number of patients or their families desperate for help to access clobazam, a benzodiazepine for which there is no suitable alternative for many patients.

A sudden discontinuation of clobazam is especially dangerous as it can cause life-threatening complications due to benzodiazepine withdrawal.

“They’re terrified that their loved one is going to die as a result of not being able to obtain this medication … I’ve spoken to people who have been seizure-free on this medication for decades. It’s the only drug that’s ever worked for some people,” she explained.

A spokesman for Apotex said the company this week released a quantity of the medication, sold under the generic name Apo-Clobazam, to distributors, who will then ship the pills to pharmacies.

“We have also received a new consignment of raw material and have commenced manufacturing more tablets,” Elie Betito said Wednesday. “Further product will be available to the market in early August.”

Health Canada has been working with manufacturers, distributors, provinces and territories, and patient groups to come up with strategies to resolve the shortage of clobazam, which is considered a “medically necessary” product, said Ken Moore, acting director of health product compliance and risk management.

Moore said there can be multiple and complex factors behind drug-supply disruptions, including problems with global supply chains and accessing raw pharmaceutical ingredients.

“The work we’re doing is trying to get a better ability to understand some of the factors at play and to be able to predict and preferably prevent shortages,” he said, adding that Health Canada has been told by the drug maker that there should be enough product available “to meet the current need.”

The Canadian Epilepsy Alliance said meeting that need is critical.

More than 300,000 Canadians are affected by epilepsy, a neurological disorder marked by sudden repeated episodes of sensory disturbance, loss of consciousness or convulsions related to abnormal electrical activity in the brain.

Not all seizures are classified as epileptic in nature. Seizures have a variety of causes, including Alzheimer’s disease, a previous brain infection or injury, or the use of certain recreational drugs or medications.

Anti-convulsive medications are the main treatment for epilepsy and other seizure disorders, but many of these drugs — not only clobazam — have been or are currently in short supply.

“About 75 per cent of the drugs used to treat epilepsy in Canada had one or more shortages in the last five years,” said Nurse, who works at Epilepsy Ontario.

“For people who live with epilepsy and their families, it’s like an active fault line has developed under their feet and the drug supply has become extremely unreliable,” she said.

“This is a crisis, and it needs to be treated as such.”

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