NEW YORK (Reuters Health) - An inexpensive drug that can prevent some life-threatening heart rhythm problems is unavailable in most places, according to a new survey of doctors in 131 countries.
Quinidine prevents arrhythmias among people with Brugada syndrome, an inherited condition in which the heart's bottom chambers quiver chaotically and don't properly circulate blood.
But because quinidine is so cheap - as low as a quarter per pill - and only indicated for a very small group of heart patients, drug companies have little incentive to go through the regulatory hurdles to market it, researchers said.
"It's a problem for a small number of patients worldwide, but it's a very serious problem because they have no other alternatives," said Dr. Sami Viskin, a cardiologist from Tel Aviv Medical Center in Israel who led the new study.
"I have patients that are desperately trying to get stocks of the medication."
For their study, Viskin and his colleagues emailed questionnaires to arrhythmia specialists and heard back from 273 doctors in 131 countries. Quinidine was readily available in just 19 of those countries, including the U.S., Australia, Brazil and France.
Doctors in 99 countries - more than three-quarters of those surveyed - said quinidine was not accessible to them. That was consistent across most of Africa, Asia and Eastern Europe.
In the remaining 13 countries, heart doctors had to go through specific regulatory procedures to get quinidine, which could take anywhere from four days to one month.
On their surveys, doctors recounted treating a total of 22 patients who had serious arrhythmias that may have been due to lack of quinine, including two people who died, the study team wrote in JACC: Journal of the American College of Cardiology.
Only about one in 10,000 people inherits Brugada syndrome and even fewer have symptoms, according to Dr. Michael Ackerman, who studies heart disorders at the Mayo Clinic in Rochester, Minnesota.
In the U.S., most people who have arrhythmias due to the disease are treated with an implantable cardioverter-defibrillator (ICD), he said. But those cost about $20,000.