Coming back to: Official shortage notices and what they authorise posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
On post #30 — agreed on the reasoning, with one qualification.
Two questions I would want answered before drawing anything from the Official shortage notices data above: how were the cases selected, and what happened to the ones that dropped out.
Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything.
If that reads as pedantic, it is, and it has saved me twice.
Adding the measurement that post #32 says would settle it.
What I want from this Official shortage notices thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check it.
The thing about Official shortage notices that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.
Switching presentation or strength during a shortage is a prescribing decision rather than a substitution anybody should improvise.
Worth one more sentence than it usually gets.
Having read the whole Official shortage notices thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead.
Shortage status determines what compounding is permitted in some jurisdictions, which links two questions that otherwise seem unrelated.
If it helps: the failure mode here is usually boring rather than dramatic.
Regional differences during a shortage are large, and a supply position in one country says nothing about another.
Post #39 describes the usual case. This is about the unusual one.
Stockpiling in response to a shortage worsens it, which is true and is a poor argument to make to somebody who has run out.
It is the kind of thing that is obvious once and never again.
I had written a reply contradicting post #43 and deleted it. Here is what survived.
The most useful contribution is a link to the current official notice rather than an account of one pharmacy.
Official shortage notices would be much easier to settle if anyone reported the denominator. Almost nobody reports the denominator.
Picking up post #47: that is the part I would want checked first.
Where an alternative within the class is available, the comparison is a clinical one and the doses are not equivalent.
That is what the documentation says. What happens in practice is usually close.
Post #47 and I disagree about the size of the effect, not about the direction.
Shortage-driven price movement is real and is a separate question from availability.
Posting it because the silence on this was starting to look like agreement.
Taking post #47 at face value and following it one step further.
Distinguishing three things in the Official shortage notices discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation that gets attached to both.
Agreed on Official shortage notices, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.
That reframing is the whole thing. The facts I already had.
Post #50 answers the question as asked. The question underneath it is different.
Pharmacy-level availability varies enormously during a shortage, so two honest accounts from the same city can be opposite.
Worth saying I have only my own numbers here, and n is small.
A shortage of one presentation is not a shortage of all of them, and the published notices are specific about which.
I keep a log of this specifically because memory is unreliable about it.
Post #54 is right about the mechanism and I think understates the practical bit.
Shortage predictions: regulators and suppliers issue shortage alerts before they become acute. Checking the regulatory website for shortages gives you advance notice.
The right answer here may simply be that it has not been measured.
Coming back to post #56, because the follow-up matters more than the original answer.
Dose hold versus tapering: if a temporary shortage forces a gap, holding your dose and resuming when supply returns is different from gradually tapering. The two are different decisions.
The short answer was in the first line; everything after is the working.
Collapsed as off-topic by two members at trust level 3 or above
Post #58 is the version of this I will quote in future. One addition.
Supply interruptions: official shortage notices are published by regulatory agencies. That is the correct primary source rather than pharmacy rumors or forum discussion.
That is all the detail I have. Someone else will have more.