This fall, with no explanation, a few very commonly used glaucoma medications (dorzolamide and dorzolamide-timolol fixed combination) became backordered and were no longer consistently available in U.S. pharmacies. Even though more than five different generic manufacturers were manufacturing the product, they all ran out basically on the same day in early September 2017. Approximately 200,000 glaucoma patients use these formulations and were left without this medication or put at significant risk. Most importantly, the manufacturers of this medication offered no explanation for why it became unavailable and offered no information on when it may become available again. Several phone calls that I placed directly to a few companies that manufacturer dorzolamide were simply not answered.
This mysterious occurrence raised many questions. Were all of the companies selling dorzolamide in the United States getting the chemical from a single source? What happened to the supply? Was there a contamination? Is an important raw material no longer available? Was there a problem that hadn’t been detected prior to the lack of availability? Physicians are left with no answers.
We would likely not tolerate this type of problem if dorzolamide were exclusively a brand name drug — and it is highly unlikely that a brand-name manufacturer would treat its customers and their patients in this manner. Yes, we pay more for brand name medications, but part of the value that is realized there is a relationship with the company and accountability from the manufacturer to both patients and physicians. Given this incident, we might take a moment to be grateful that many of our patients suffering from glaucoma can be treated with brand name products, which have manufacturers that stand strongly behind them, and provide a consistent source of medications to protect our patients from blindness.
Dr. Nathan M. Radcliffe is a clinical associate professor of ophthalmology at New York Eye and Ear Infirmary and is a cataract and glaucoma surgeon at the New York Eye Surgery Center.