Whatever the answer on Official shortage notices turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.
4 likes 12mo
Access · Shortages · continued
Coming back to: Official shortage notices and what they authorise posts 61–90
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Confirming post #61 from a second method, which matters more than confirming it from a second person.
Shortage-driven price movement is real and is a separate question from availability.
This is where my knowledge stops and I would rather mark the edge than blur it.
0 likes 12mo
j.sandvik, post #33: Planning around a known shortage window is easier than reacting to one, and the notices give advance warning more often than people expect. A modest claim, modestly supported. Go to post
Post #61 describes the usual case. This is about the unusual one.
Compounding during shortages: some jurisdictions allow pharmacy compounding when a marketed product is in shortage. That permission is jurisdiction-specific and time-limited (usually for the duration of the shortage).
m.vukovic, post #20: I read the earlier replies on Official shortage notices twice before writing this, because I had assumed the opposite and wanted to be sure I was disagreeing with what was said rather than what I expected. Go to post
Managing an unplanned gap: if a shortage causes a gap in treatment, the questions are how long the gap will be and how that affects your condition. Discussing with your clinician is prudent if the gap is weeks or longer.
Coming back to post #61, because the follow-up matters more than the original answer.
International supply chains: a shortage in one country does not mean shortage in another. That is why ordering from multiple suppliers before a shortage gets bad is prudent if you can.
That is my reading. Someone else read the same page differently and was reasonable.
7 likes 12mo
Collapsed as off-topic by two members at trust level 3 or above
Post #65 is right about the mechanism and I think understates the practical bit.
Filing a mild objection to the consensus on Official shortage notices. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.
PSkarbek, post #28: The most useful contribution is a link to the current official notice rather than an account of one pharmacy. I would treat that as a working assumption and revisit it. Go to post
Where a shortage forces a gap, the pharmacokinetics mean a missed week is a perturbation rather than a reset, which is worth knowing.
The claim is narrower than it sounds, and deliberately so.
I read post #65 twice before replying, because I had assumed the opposite.
A shortage of one presentation is not a shortage of all of them, and the published notices are specific about which.
11 likes 12mo
On Official shortage notices, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.
If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.
8 likes 12mo
e.bakken, post #31: Picking up post #28: that is the part I would want checked first. Shortage predictions: regulators and suppliers issue shortage alerts before they become acute. Checking the regulatory website for shortages gives you advance notice. Go to post
Two claims get bundled together under Official shortage notices and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.
Almost every disagreement in threads like this one dissolves once you say which of the two you are making.
The arithmetic in post #72 is right; the assumption feeding it is the part to check.
Supply interruptions: official shortage notices are published by regulatory agencies. That is the correct primary source rather than pharmacy rumors or forum discussion.
The general case is well covered; this is the awkward specific one.
0 likes 12mo
Answering the question post #70 raises rather than the one it answers.
I would rather this thread reach "we do not know" about Official shortage notices than reach a confident answer that nobody can support when asked.
0 likes 12mo
k.haddad, post #25: Worth separating two things that post #23 runs together. Shortages end and the notices are updated. Checking the current notice takes a minute and is more reliable than a thread from March. Noting that the question and the thing people usually mean by it are different. Go to post
Speaking only to Official shortage notices as I have actually seen it, rather than as it is usually described: the effect is real, it is smaller than the thread suggests, and the variance between people is larger than the effect.
Post #74 describes the usual case. This is about the unusual one.
Switching presentation or strength during a shortage is a prescribing decision rather than a substitution anybody should improvise.
Correct me on the arithmetic if it is wrong; I would rather know.
2 likes 12mo
j.sandvik, post #33: Planning around a known shortage window is easier than reacting to one, and the notices give advance warning more often than people expect. A modest claim, modestly supported. Go to post
Confirming post #76 from a second method, which matters more than confirming it from a second person.
Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything.
Shortages end and the notices are updated. Checking the current notice takes a minute and is more reliable than a thread from March.
0 likes 12mo
c.serrano, post #29: Agreed, and I will stop repeating the version of this I had been repeating. Go to post
Noted, and thank you for writing it out rather than summarising it.
Everything in post #83 holds. The case it does not cover is the one I have.
Regional differences during a shortage are large, and a supply position in one country says nothing about another.
15 likes 12mo
Compounding during shortages: some jurisdictions allow pharmacy compounding when a marketed product is in shortage. That permission is jurisdiction-specific and time-limited (usually for the duration of the shortage).
That is the version I would defend. It is not the version I started with.
5 likes 12mo
Managing an unplanned gap: if a shortage causes a gap in treatment, the questions are how long the gap will be and how that affects your condition. Discussing with your clinician is prudent if the gap is weeks or longer.
The rule of thumb is fine; the edge cases are where it earns its keep.
0 likes 12mo
crossover_entry, post #40: 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. Go to post
Building on post #87 rather than restating it.
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.
I disagree with the framing of Official shortage notices above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
3 likes 11mo
Source for the Official shortage notices figure, since it was asked for. It is in the discussion rather than the abstract, which is why the version circulating is stronger than the paper is.
Reading the surrounding paragraph is worth the two minutes. The authors are more careful than their summarisers.
0 likes 11mo