Triage in the Nation's Medicine Cabinet: The Puzzling Scarcity of Vaccines and Other Drugs

38 Pages Posted: 27 Sep 2002

See all articles by Lars Noah

Lars Noah

University of Florida Levin College of Law


For a variety of reasons, vaccines and other critical pharmaceutical products have become increasingly scarce in the last few years, and persistent shortages involving dozens of essential drugs may imperil the public health. Pressures emanating from regulatory agencies, the courts, and insurers have conspired to make some lines of the pharmaceutical business less than attractive. Although concerns about unpredictable tort liability received most of the blame in the past, two other factors may help to account for the latest round of drug shortages: stringent federal control of manufacturing facilities and aggressive cost-containment efforts that further erode profit margins. Whatever the cause, scarce supplies necessitate efforts at rationing that pose their own difficulties for health care providers. Policymakers could avoid putting physicians to such tough choices among patients by focusing on ways to ensure the production of adequate quantities of these highly cost-effective medical technologies. Some commentators have called for greater public sector involvement, but this Article concludes that, in addition to bolstering its emergency stockpiles, the federal government instead needs to take steps designed to encourage private manufacturers to continue supplying critical pharmaceuticals. To this end, it should adopt more flexible regulations governing manufacturing facilities, provide companies with greater protection from the vagaries of tort liability, and avoid pursuing excessive cost-control strategies. Otherwise, patients may continue to lose access to important therapeutic products.

JEL Classification: I18, K13, K23

Suggested Citation

Noah, Lars, Triage in the Nation's Medicine Cabinet: The Puzzling Scarcity of Vaccines and Other Drugs. South Carolina Law Review, Vol. 54, December 2002, Available at SSRN: or

Lars Noah (Contact Author)

University of Florida Levin College of Law ( email )

P.O. Box 117625
Gainesville, FL 32611-7625
United States
352-273-0923 (Phone)
352-392-3005 (Fax)


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