Propofol as a lethal injection could lead to EU sanctions, potentially putting millions of U.S. patients at risk

Fresenius Kabi takes no position on capital punishment. But we object in the strongest terms to the use of Propofol in lethal injections, in order to ensure the safety and availability of Propofol for patients and those who care for them. If Propofol were to be used in executions, the European Union (EU) will most likely impose restrictions on Propofol exports to the U.S. By far the largest share of Propofol available to U.S. health care facilities is manufactured in Europe. The EU export restrictions will therefore severely restrict U.S. access to the most widely used anaesthesia drug, potentially putting millions of patients at risk.

EU export restrictions of Propofol would put patient safety at risk

The EU has outlawed capital punishment, and also stated publicly it would work towards worldwide abolition of the death penalty. In accordance with that approach, Council Regulation 1236/2005 was implemented in the EU to prohibit trade in goods which could be used for capital punishment, torture or other cruel, inhumane treatment of individuals.

Since the U.S. state of Missouri announced the change of its lethal injection protocol to use Propofol, the European Commission has consistently indicated that if a prisoner is executed with Propofol, the drug would become subject to strict export controls under the Regulation – even if the Propofol used in the execution was manufactured outside the EU.
As soon as Propofol were to be added to the Regulation, national authorities would be obliged to implement an export ban. From that point forward, Fresenius Kabi as well as other manufacturers would have to apply to export authorities in Europe (such as the Federal Office of Economic Affairs and Export Control in Germany) for an export license for each specific shipment of Propofol, a process that could take 3-6 months in every instance.

Given the extensive amount of EU-manufactured Propofol needed for U.S. patient care, this would inevitably result in a significant market shortage of this medically necessary drug across the U.S.