Sunday, February 18, 2007 Mercado: Expired drugs: reactions By Juan L. Mercado
(FROM Georgia to Laguna, there were trenchant reactions to this column on what expiry dates on medicine bottles or packets mean. From Maryland, a US Food and Drug Administration staff member asked for a copy of: "To Junk or Not to Junk."
(That column reported that Harvard University's School of Medicine, Brigham Young University Hospital, among others, reveal that studies of US Armed Forces $1-billion medicine stockpiles concluded: most medicines remain effective even 15 years beyond expiration dates. Extending shelf-life of medicine prevented the US military from trashing useful medicine at substantial savings – JLM)
From Emory University Hospital pharmacy in Atlanta Georgia, Patrick H. O'Brien e-mailed: "(I'm) a US pharmacist who worked with eight medical/ surgical missions to the Philippines. Two were to Tagbilaran City in 1992 and 1994. And I applaud the common sense and non-political approach to the issue of expiration dating on medications in this un-biased column.
"As with most things, expiration dates are simply guidelines to be used.
Medications are more affected by storage conditions than by a simple date.
How many of us have gotten relief from a headache from a Tylenol that passed its expiration date? How many of us actually look?
"The well intentioned Bureau of Food and Drugs (BFAD) advises that medicines, imported by foreign medical missions, must have at least a one year expiration date. That requirement may be appropriate for international pharmaceutical companies’ imports. But it puts an enormous burden on medical mission donations. They receive most of their donated drugs with a short expiration date of two to six months. How can I request donations then demand a one year expiration date?
“Our mission group will leave for a surgical mission to Roxas City. We accumulated medicines that are not expired but lack BFAD's one year required dating. Worse, efforts to contact the BFAD to arrange an inspection, by e-mail, regular mail and phone, all went unanswered. Maybe they’re busy dreaming up other rules?”
Retired University of the Philippines professor Dr. Flor Lacanilao wrote: "Your column is relevant because many of our people are poor. And misinformation about expiry dates denies them perfectly good medicine.
“Studies reveal that most medicines remain effective beyond expiry dates which are merely indicative. If they are stored carefully, most medicines remain effective. In tropical countries like the Philippines, shelf life may be shorter if the packaging is opened.
“There are many reasons why BFAD is ineffective. But the major flaw stems from the fact that this agency has very few scientists."
Cebu business executive Josephine Aboitiz Booth e-mailed: "I’ve just read your article on expired medicines. And I do recall when the news report first came out after the US military received the study (on their medical stockpiles) after spending $4 million. The conclusion was that many medicines are still good way past their expiry date.
"Here we are, with so many sick poor, without access to medicines. I think it is worth the 'gamble' to give them so-called 'expired' medicines with a 70 to 90 percent chance rather than nothing! Every operation is a gamble. And yet we have to have them.
“Some people act as just holier than thou but offer no other option. I now take expired medicines myself that have been sitting in my medicine cabinet."
Dr. Napoleon Vergara served with the United Nations at the Food and Agriculture Organization, in Rome and various countries. Previously, he taught at UP Los Banos. He writes: "I've read your report on expiry dates on medicines---and was reminded how expiry dates on many other products should not be taken literally.
"Take one item: photographic film. My thesis required extensive use of photographs. And I was short of film. What I had was so called "expired" film. Photographers advised me that if carefully stored and packed, film would be good long after expiry dates. And they proved right.
"What is tragic is so many people are needlessly denied perfectly good medicine. Our officials and agencies simply are so outdated and so inept."
Jove Trinidad e-mailed but didn’t give his background, address, etc. Editors promptly wastebasket such letters since they lack candor and dodge accountability. We make an exception because some questions--–assertions, really---show the confusion.
Trinidad writes: “Did your research…look into the question if there has been a study of specific drugs expiry dates"? (The US Food and Drug Administration did the research. Not me. Allow me to decline the honor. And, yes FDA studied 100 specific drugs in the military stockpile. In fact, the column reported several examples.)
“Are ‘expired medicines’ sold to Filipino resellers by foreign drug suppliers? Do the latter, knowing fully well that they are ‘expired drugs’ but are acquiring them (sic) because they are being sold to them as discounted items? Are boticas selling ‘expired drugs’ to the public? More likely, than not I bet.”
(Questions or accusations? Since the writer is willing to bet, he should share his “research.” The poor will know why they lack medicine.)
