Will Drug Shortages Endanger Your Life?

One of the most under-reported health care problems in the US has to do with shortages of essential medications. We have been concerned about this serious problem for more than a decade. In the November, 2011 issue of Pharmacy and Therapeutics (P&T) the headline was “The Drug Shortage Crisis in the United States.” The author establishes that “There have been increasingly frequent drug shortages in the U.S. during at least the past decade.” That means we have been facing this serious problem for more than 20 years! Will drug shortages ever end?

A New Report on Drug Shortages:

The hand wringing about our inadequate medicine supply chain has been going on for a very long time. No one seems to know what to do about it. A new analysis suggests that it is just getting worse.

The March 2023 report is titled:

SHORT SUPPLY

“The Health and National Security
Risks of Drug Shortages”

It was prepared for the US Senate Committee on Homeland Security & Governmental Affairs. The report says that shortages of critical medications have been increasing, lasting longer and impacting patient care.

Will Drug Shortages Affect Health?

Parents may have noticed that children’s fever-reducing medicines were in short supply last month. More alarming, though, are inadequate supplies of medications critical for emergency and other hospital care.

In recent years there have been long-lasting shortages of certain antibiotics, IV fluids, anesthetics and anticancer drugs. People with attention deficit hyperactivity disorder have had difficulty obtaining the drug Adderall or its generic equivalent. When people cannot obtain this medication, they may experience withdrawal symptoms. Will drug shortages of this medication impact the mental health of millions of people? You can read more about such problems at this link.

Asthma patients have had challenges finding the bronchodilator albuterol, a staple for people with breathing problems. Anyone who has ever had trouble catching their breath knows how scary it is if you do not have effective medicine at the ready.

How Bad Is It Really?

According to the report prepared for US Senate Homeland Security Committee:

“Between 2021 and 2022, new drug shortages increased by nearly 30 percent. At the end of 2022, drug shortages experienced a record five-year high of 295 active drug shortages. While the average drug shortage lasts about 1.5 years, more than 15 critical drug products have been in shortage for over a decade. Shortages continue to have devastating consequences for patients and health care providers, including medication errors and treatment delays, and in some cases, have led to doctors having to ration lifesaving treatments.”

That’s bad! Really bad! And no one knows what to do about it.

Why Will Drug Shortages Continue?

The report to the Senate notes that the drug supply chain is opaque. That means there is a tremendous amount of secrecy surrounding this national crisis.

There is:

“Overreliance on foreign and geographically concentrated sources for critical drugs and their key starting materials and limited domestic manufacturing capabilities create health and national security risks”

The report specifically notes that:

“Between 2010 and 2015, the number of Chinese-based API [active pharmaceutical ingredient] manufacturers registered with the FDA more than doubled from 188 in 2010 to 445 in 2015…90 to 95 percent of generic sterile injectable drugs for critical acute care in the U.S. rely on key starting materials and drug substances from China and India.”

Who’s in Charge?

There is no oversight. Drug companies are on their own in determining how much and what they will manufacture. The FDA has virtually no authority, other than to alert health care professionals of shortages. What good does it do a hospital or a doctor to know that a cancer drug is in short supply if there are no good alternatives?

People keep talking about bringing back drug manufacturing to the United States. But generic drug manufacturing is a cut-throat business. As long as the FDA keeps approving products made in foreign plants that are not closely monitored, drug chain buyers in this country will purchase the cheapest pharmaceuticals they can get away with. No one gets rewarded for quality!

Will drug shortages go away on their own? Not bloody likely! Unless Congress establishes incentives for domestic manufacturing, drug testing and pharmaceutical quality, this problem is likely to continue and get worse.

You can read the report yourself at this link. Here is an article we wrote about how a drug shortage threatens children with cancer. If you are as angry as we are that this is happening, please let your Congress person know that it is time to stop talking and put an end to this health crisis!

What would you do if a critical medicine you rely on became unavailable? Will drug shortages endanger your life some day? Quite possibly!

Comments welcome below.