[Why&Next] Injectable Drugs Cheaper Than 'MyChew'... Essential Pediatric Medicines, But the More They're Made, the More Losses Occur

Reasons Behind Essential Drug Shortages Revealed by Ativan Supply Disruptions

71% of Pediatric Hospitals Report "Stock Will Run Out Before July"

Budesonide and Fever-Reducing Syrups Also Frequently in Short Supply

"Urgent Need for Pri

Essential injectable drugs used in pediatric emergency rooms and children's hospitals are facing successive supply disruptions, putting the medical field on high alert. The government is urgently seeking alternative pharmaceutical companies to secure emergency supplies, but on-site inventories have already been depleted, raising concerns that a "medical crisis" could erupt this summer.

According to the medical community on May 18, the supply of Ativan (active ingredient: lorazepam), an essential first-line treatment for pediatric seizure patients, was recently suspended, and the production of Cortisol Injection (hydrocortisone sodium succinate) for newborn blood pressure control is scheduled to cease starting July.

The Ministry of Food and Drug Safety is pursuing a plan for Samjin Pharmaceutical to produce Ativan as a substitute for the previous manufacturer and supplier, Ildong Pharmaceutical. Although the supply of Cortisol Injection is expected to resume around November or December, both drugs are likely to experience a supply gap between the exhaustion of current inventories and the arrival of new products.

An urgent fact-finding survey conducted by the Korean Association of Pediatric Hospitals on pediatric hospitals nationwide found that 34% (12 out of 35 respondents) had already run out of Ativan injectables, making it impossible to treat emergency patients. Furthermore, 37% (13 hospitals) answered that "their stocks are expected to run out within one to two months," indicating that 71% of the hospitals will almost certainly face paralysis of medical care due to Ativan shortages before summer arrives. Among these hospitals, 23% said they had transferred patients to other hospitals in the past six months due to unstable Ativan supply, while 43% of medical staff reported experiencing severe stress due to concerns about side effects from using alternative drugs.

Repeated Shortages in Pediatric Care

The medical community points out that this situation was essentially predictable. Lee Hongjun, Director of Gimpo iJaeil Hospital, explained, "The price of a single Ativan ampoule is only 782 won, which is less than a pack of the candy 'MyChew' that children often eat," adding, "Low profitability and excessive regulation are intensifying the disappearance of essential medicines with public good characteristics from the market." As production costs such as raw materials and labor rise sharply each year while drug prices remain frozen, pharmaceutical companies face a structure where manufacturing leads to losses.

For Cortisol Injection, the highest price is reportedly only 820 won per 100mg vial, and just 410 won for a standard newborn dose (50mg). Due to this low pricing structure, the burden of production has increased, and the manufacturer has halted the production line citing equipment maintenance.

Budesonide inhalation, a respiratory treatment essential for relieving the airways of pediatric croup (laryngotracheobronchitis) patients, is also experiencing ongoing inventory depletion due to continued supply shortages. Whenever colds or influenza are prevalent, fever reducers such as acetaminophen syrup become scarce, with pharmacies and hospitals competing to stockpile them.

Han Donggyun, Director of Mirae Children's Hospital in Nam-gu, Gwangju, lamented, "Due to the impact of declining birth rates, the use of essential pediatric medicines has significantly decreased, making producers reluctant to manufacture them. As a result, it has become common to divide and administer adult medications to urgent pediatric patients when the necessary pediatric drugs are unavailable."

Especially regarding the health authorities’ claim that there is no major problem because alternative drugs exist, specialists criticize this as "armchair theorizing that ignores clinical realities and is a dangerous idea that puts children’s lives at risk." Ativan, as the only medication that acts rapidly within 5 to 10 minutes to protect the brain during the crucial golden time, is considered the safest and irreplaceable first-choice drug for children due to its minimal respiratory stimulation compared to other medications.

Cortisol Injection is the only medication available for extremely premature infants or critically ill newborns and children whose blood pressure does not rise even after receiving fluids or vasopressors. While alternative drugs exist for adults, there are none for newborns, according to the consensus in the medical community.

Choi Yongjae, President of the Korean Association of Pediatric Hospitals (Director of Ttuntun Children's Hospital in Uijeongbu, Gyeonggi Province), emphasized, "For these ultra-low-priced essential medicines, a separate system is needed for the government to compensate for production and management costs, and an 'automatic trigger system' should be established, where relevant agencies respond jointly as soon as a report of supply suspension by a pharmaceutical company is received."

This content was produced with the assistance of AI translation services.