Another chapter in the story, "Why Health Care and the Free Market Don't Mix"

[Sauron]

Clotting drugs are expensive. VERY expensive. Fortunately, a cheap alternative is available. Only hospitals aren't using it.

But hospitals are always suffering budget crises. Wouldn't they want to use it? Probably. What's the problem?

A Cheap Drug Is Found to Save Bleeding Victims
By DONALD G. McNEIL Jr.

For months, a simple generic drug has been saving lives on America’s battlefields by slowing the bleeding of even gravely wounded soldiers.

Even better, it is cheap. But its very inexpensiveness has slowed its entry into American emergency rooms, where it might save the lives of bleeding victims of car crashes, shootings and stabbings — up to 4,000 Americans a year, according to a recent study.

Because there is so little profit in it, the companies that make it do not champion it.

However, the drug is edging slowly closer to adoption as hospitals in New York and other major cities debate adding it to their pharmacies. The drug, tranexamic acid, has long been sold over the counter in Britain and Japan for heavy menstrual flow. After a groundbreaking 2010 trial on 20,000 hemorrhaging trauma patients in 40 countries showed that it saved lives, the British and American Armies adopted it. The World Health Organization added it to its essential drugs list last year, and British ambulances now carry it.

But outside Britain, it is used in very few civilian hospitals, though almost six million people around the world die each year of trauma — 400,000 of them in hospitals. A study published March 1 in BMC Emergency Medicine estimated that the drug could save up to 128,000 of those lives a year, 4,000 of them in the United States.

The slowness of American hospitals is due to “inertia,” said Dr. Ian Roberts, clinical trials director for the London School of Hygiene and Tropical Medicine and leader of the 2010 trial, which was called Crash-2. “The people who do the urging and the talking about new drugs are the pharmaceutical companies, and if they’re not interested, it’s not done.”

Many companies in India and China make tranexamic acid. Pfizer, which makes an injectable form for hemophiliacs (and donated thousands of doses to the Crash-2 trial), declined to give sales figures or even discuss administering it to trauma patients because the Food and Drug Administration has not approved that use. A company spokeswoman declined to say whether Pfizer had applied for approval. (Doctors may prescribe approved drugs for “off-label” uses, but drugmakers cannot endorse off-label uses without F.D.A. permission.)

[Angakuk]

Does there exist a procedure which would allow a third party to apply to the FDA for an off-label use of a drug? If there isn't such a procedure there certainly should be.