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B12 supply expected to increase

But prices likely to jump

April 3, 2014
Fort Myers Beach Bulletin, Fort Myers Beach Observer

The good news is that an important prescription vitamin in extremely short supply for the last few months will likely soon be readily available.

The bad news is patients should get ready for a reported jump in the cost for the B12 serum, a prescription injection used to help treat health disorders affecting several million Americans.

Pharmacists, in fact, are told to expect a sharp rise in the cost of the frequently prescribed supplement, Sanibel Island pharmacist Reggie Mathai said.

"We don't know exactly where this is going," Mathai said, "but we're being told new prices, significant new prices."

The prescription B12 serum has been in limited supply since November.

The distributor, New York-based American Regent, cited new regulations, demand, back orders and shipping delays as reasons for the limited supply, frustrating doctors who prescribe B12 for those with severe anemia and other health issues, Mathai said.

American Regent "has been saying it's a short-term thing for a couple of months," said Mathai, owner of the Island Pharmacy on Sanibel. "But it has been a little more than short term. I don't know where (this) is going. We're being told new prices and no reimbursement."

American Regent did not immediately return calls to confirm the price adjustments. American Regent in the last few years has recalled B12 vials for reported contamination issues. A spokesman for CVS Pharmacy said the huge retailer will not carry the prescription supplement.

The medical term for the most common B12 serum is cyanocobalamin. Some pharmacies had stockpiled the B12 vials, but it has mostly been unavailable, forcing sufferers to find alternatives like over-the-counter pills, nasal sprays and liquids absorbed under the tongue. Even then, many of the cyanocobalamin vials were expired, further limiting access.

Cyanocobalamin has been prescribed for those suffering pernicious anemia, along with other disorders. It is also used to supplement insulin for diabetics. It is mostly prescribed to those with a vitamin deficiency and who cannot absorb food properly. Healthier people have enough natural B12 in the liver. Some doctors say a different diet and reduced use of some prescription drugs that block digestion would fix the problem without dependency on expensive B12 injections.

Federal agencies have stepped up efforts to limit drug shortages for a couple of years. President Obama in 2011 signed Executive Order 13588, which is intended to force drugmakers to report shortages or anticipated problems. The Order, in part, says: "Shortages of pharmaceutical drugs pose a serious and growing threat to public health. While a very small number of drugs in the United States experience a shortage in any given year, the number of prescription drug shortages in the United States nearly tripled between 2005 and 2010, and shortages are becoming more severe as well as more frequent."

A US Food and Drug Administration official said authorities are limited in what can be enforced, however, in terms of drug supplies and pricing. Government agencies are stepping up efforts to better inform the public, the spokesman said. Pricing, unfortunately, is driven by strictly "market forces," FDA spokesman Chris Kelly said. "We are working with the company to resolve" the shortage issue.



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