Korean Pediatric Hospitals Warn of Treatment Crisis as Ativan Shortages Persist

A significant number of pediatric hospitals in Korea are warning of a treatment crisis due to supply disruptions of Ativan (generic name: lorazepam), an essential medication for children. The hospitals have urged health authorities to establish a system to eliminate recurring shortages of essential pediatric drugs, including Ativan.

The Korean Pediatric Hospital Association held a press conference Tuesday to release the results of a survey of 35 hospitals. When asked about their current Ativan injection inventory and the resulting impact on treatment, 12 hospitals responded that "stocks have already been depleted, making it impossible to treat emergency patients." Another 13 hospitals said "supplies are expected to run out within one to two months, and a treatment crisis is certain to occur before July." In total, 25 of the 35 hospitals (71.4%) viewed the current situation as a crisis.

Ativan is a benzodiazepine-class anti-seizure medication that quickly calms seizures by suppressing excessive neural excitation in the brain. Medical professionals on the front lines describe Ativan as "the airbag of the emergency room."

Given its clinical importance, Ativan is currently designated as both a national essential medicine and a withdrawal-prevention medicine. However, Ildong Pharmaceutical, which has been supplying Ativan injections in Korea, announced in December last year that it would cease production.

When asked about the view that there is no major problem because alternatives such as midazolam and diazepam are available, 24 of the 35 hospitals (69%) responded that such a position is "armchair theory and a dangerous idea that puts patients' lives at risk."

The Ministry of Food and Drug Safety said its policy is to ensure smooth supply until the procedures for product transfer and change approval are completed, with Ildong Pharmaceutical having produced additional units of the product in the second half of last year.

Samjin Pharmaceutical, which will take over the product, is expected to apply for change approval this month, and the ministry said it will promptly review the related procedures.

Pediatric hospitals also cited "Ventolin Nebules," a first-line treatment for acute respiratory distress in infants and toddlers; "Pulmicort Respules," an inhaled steroid for severe pediatric asthma; and syrup-form fever reducers and antibiotics as drugs that frequently run out.

The Korean Pediatric Hospital Association stressed that "going forward, whenever any drug regulation is introduced, a 'supply impact assessment' analyzing its effect on the essential medicine supply chain must be made mandatory." The association added, "If production costs rise due to regulation, drug prices must be immediately adjusted upward in tandem, and the production costs and management expenses of ultra-low-priced essential medicines must be fully reimbursed."