Fresenius Restricts Use of Propofol for Executions

Fresenius Restricts Use of Propofol for Executions

September 27th, 2012 // 2:18 pm @

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As a result of a campaign by activists to pressure drugmakers to prevent their medications from being used in the US for lethal injections, Fresenius Kabi recently adopted a new policy in which orders from any corrections officials for its Propofol drug will be rejected. Propofol is an anaesthetic that has been used for executions in the wake of shortages of other medications. The move is seen as significant because Fresenius is the sole supplier in the US.

Late last month, the German drugmaker wrote a letter to healthcare providers to say that using Propofol for executions is “contrary to the FDA approved indications” and “inconsistent” with its “mission” and “objects to the use of its products in any manner that is not in full accordance with approved indications.” The August 28 letter, which was only disclosed publicy as of today, was signed by Scott Meacham, the chief commercial officer for Fresenius Kabi USA.

As part of its plan to restrict Propofol for use in executions, the drugmaker will only ship the drug to select wholesalers and distributors that agree to resell the medication to acute care hospitals, clinics and health care facilities where its use is medically necessary. These customers must also agree not to resell Propofol to any correctional facilities and exclude shipment to retail pharmacies, according to the letter (read it here).

Activists were heartened by the move. “The swift, ethical action which they have taken to prevent their involvement in the lethal injection drug trade is an outstanding example to other companies in their field,” writes Maya Foa, an investigator with Reprieve, a UK Charity that is organizing the campaign. “US correction departments need to understand that pharma companies do not want to see their products used in executions.”

As we reportedly previously, the organization earlier this year publicized what it calls the Pharmaceutical Hippocratic Oath, which drugmakers are being asked to sign and pledge that their medicines will be used to ‘help, not harm.’ So far, Lundbeck has agreed to participate and an effort is getting under way this week to prompt others to do the same, according to Foa.

The campaign comes amid a growing controversy over the importation of certain medications for lethal injections. Earlier this year, a federal judge chastised the FDA for allowing various states to import thiopental sodium for use in executions and the agency was ordered to notify state corrections departments that the use of sodium thiopental was prohibited and had to be returned (back story).

In response, 15 state attorneys general wrote a letter to US Attorney General Eric Holder, urging the Justice Department to appeal the FDA move to restrict use of the drug because this “undermines the ability of states to properly enforce capital punishment laws.” The FDA then appealed the ruling by US District Court Judge Richard Leon, who claimed the agency violated federal law, because there was no safety and effectiveness review for the medication (read more here).

Meanwhile, the UK Charity is also targeting Hospira. As we reported earlier this year, more than two dozen prominent physicians from different countries published a letter in The Lancet to Hospira ceo Michael Ball, urging him to restrict the use of Pancuronium, which is one of three drugs that are used in a lethal injection cocktail administered by many states in the US that still employ the death penalty (read here).

In a response in the same issue of the medical journal, Ball wrote that Hospira does not support the use of its drug for lethal injections and maintains the drugmaker has written to various states to underscore that point. As to taking any specific steps, though, he was vague, because Hospira is concerned that restricted distribution may jeopardize legitimate patients. As to the Oath, Foa says Hospira has not yet signed the document.


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