The executive order acknowledges that legislation is an important step in solving the problem, but sees these steps as immediate action that can be taken until Congress acts.

The balance of regulation and free enterprise is tricky.  The profit motive and the free enterprise system has given us wonderful life-saving drugs.   The scientists who develop drugs and the workers who produce them deserve a living wage even after a drug's patent expires.  Unfortunately, the profit motive can also lead corporations to forget their responsibility towards the greater good.

Today it is hard for us to imagine a time when anyone could pour some alcohol and colored water in a bottle and claim that it could cure cancer and the common cold.  Yet the Food and Drug Administration was started in 1906 just because of that kind of abuse.  Dangerous drugs and impure food were harming consumers, who had no way of testing the efficacy or safety of medicine and food.

Breast cancer patients are at the heart of this balance.  Because many of the drugs that work well for us are now out of patent and less expensive,  cancer treatment need no longer be the financial disaster that has affected so many of us.  Yet we also want new drugs to treat more resistant cancers like triple negative tumors.  New drugs take research, and research costs money-money that comes from the profits of earlier drugs and money from investors who expect a return on their investment.

In a perfect world, corporations would be good citizens concerned not only with their bottom line, but also with the welfare of their customers.  Surely, there is a way they can make a sufficient profit on their generic drugs to stay in business.  Aspirin has been generic for years and years, but plenty of manufacturers are still making it profitably. 

Unfortunately, I have become rather cynical about big pharma.  I hope this executive order reduces shortages.  I suspect it will probably require legislation to move reporting from voluntary to mandatory to make effective drugs available for all.

If drug shortages have affected your cancer treatment, we would like to hear about your experience.  How has your doctor managed?  What steps do you think need to be taken to make sure that every patient has access to the most effective drugs?