Leflunomide offers a big window onto some worrisome trends in the pharmaceutical industry, including manufacturing problems and drug shortages that can result not just in price spikes, but in big disruptions in patient care - sometimes even deaths.It's not entirely clear why leflunomide became scarce, or who benefited from the price increases. The good news is that at least they appear to have been temporary. One clear factor in the shortage was a suspension in imports by Apotex, the U.S. arm of a Canadian maker of generics, after inspectors from the U.S. Food and Drug Administration found problems at two of its Toronto facilities in September 2009.