Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything. A weak preference rather than a position.
Substitution between formats during a shortage — what changed since — setting out what I have, and where I think it stops being reliable.
What changes if the standard account of Substitution between formats is wrong? I ask because I have been treating it as settled and I noticed this week that I could not say why.
Working through the consequences rather than the evidence, since others here are better placed on the evidence.
Manufacturer allocation decisions during a shortage are commercial and are rarely explained, which is frustrating and is not evidence of anything.
A weak preference rather than a position.
International supply chains: a shortage in one country does not mean shortage in another. That is why ordering from multiple suppliers before a shortage gets bad is prudent if you can.
Noting that I have skin in this question and have tried to discount for it.
Everything in post #3 holds. The case it does not cover is the one I have.
The published shortage register maintained by the national regulator is the authoritative source here, and it is updated far more often than any thread.
Adding the caveat now so it does not have to be extracted later.
I disagree with the framing of Substitution between formats above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
Shortage status determines what compounding is permitted in some jurisdictions, which links two questions that otherwise seem unrelated.
That is where I would start, not where I would stop.
Understood, and I withdraw the assumption I opened with.
Everything in post #10 holds. The case it does not cover is the one I have.
The strongest argument against my own position on Substitution between formats, stated as well as I can state it, since nobody else has yet.
Allocation and rationing: during severe shortages, suppliers might ration allocation to prescribers. Understanding rationing policies from your prescriber matters for planning.
Switching presentation or strength during a shortage is a prescribing decision rather than a substitution anybody should improvise.
Post #16 is the version of this I will quote in future. One addition.
Dose hold versus tapering: if a temporary shortage forces a gap, holding your dose and resuming when supply returns is different from gradually tapering. The two are different decisions.
The answer changed when I changed how I was measuring, which was informative.
That matches what I have seen, for whatever a single anecdote is worth.
Staff rationale: Hidden by community flags. Contained an unredacted laboratory report with identifiers visible (R12). The analytical content has been quoted back into the topic without them.
This is the answer, and the reason it is the answer is the more useful part.
The corresponding entry is in the public moderation log. Hidden posts are never deleted.
This follows post #19 rather than contradicting it.
Planning around a known shortage window is easier than reacting to one, and the notices give advance warning more often than people expect.
One more caveat and then I will stop qualifying: the sample selected itself.
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