US Pharmaceutical Drug Shortages Reach Record High

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New data show a shortage of 323 prescription drugs—the highest number since data collection began in 2001.

Despite efforts to stabilize the availability and cost of medications, prescription drug shortages have reached record highs in the United States.

Fourteen more drugs have experienced a shortage since the organization’s July survey, which found 309 medications in short supply.

Drug shortages have often made U.S. headlines in recent years. The July 2023 ASHP survey found that 85 percent of hospitals and pharmacies were rationing drugs, and over 40 percent were delaying appointments due to the national pharmaceutical drug shortage.

The report also highlighted that basic and life-saving drugs are in short supply, including oxytocin, Rho(D) immune globulin, standard-of-care chemotherapy, pain and sedation medications, and attention-deficit/hyperactivity disorder (ADHD) drugs.

Classes of drugs in short supply include central nervous system (CNS) drugs, antimicrobials, electrolytes and fluids, chemotherapies, and hormone drugs.

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For the most part, manufacturers failed to provide a reason or didn’t know the reason for the shortage, ASHP reported. Fourteen percent of manufacturers reported that supply/demand issues were to blame, 12 percent blamed manufacturing, 12 percent blamed business decisions, and 2 percent said raw material issues were the main factor.

The constant shortages and supply chain issues have pressured the Biden administration and other lawmakers to help increase domestic production of critical medications. Lawmakers have also launched investigations into why pharmaceutical companies have been unable to manage the bottleneck.

Managing drug shortages is laborious and costly, the ASHP noted. A 2019 analysis estimated the annual labor cost of drug shortages to U.S. hospitals was $359 million. Additionally, purchasing alternative package sizes or concentrations of drugs, sourcing from other suppliers, or sourcing alternative products adds to the hefty cost.

FDA Bears Brunt of Blame

In November 2023, the House Committee on Oversight and Accountability called on the U.S. Food and Drug Administration (FDA) to respond to the shortage. At the time, the FDA listed 128 drugs as in short supply. That number has since risen to 153.

“Current shortages include important drugs commonly used to treat infections, respiratory illnesses, heart failure, psychiatric conditions, and cancer, and include drugs such as amoxicillin, penicillin, albuterol, Adderall, and cisplatin/carboplatin,” Reps. James Comer (R-Ky.) and Lisa McClain (R-Mich.) wrote to Dr. Robert Califf, the commissioner of Food and Drugs at the FDA, in November 2023. “The cancer drug shortage has gotten so severe that the FDA temporary [sic] authorized the importation of drugs produced by non-FDA approved Chinese manufacturers. The FDA is failing to ensure vitally important pharmaceuticals remain on pharmacy shelves.”

The committee held a hearing on Thursday, April 11, with Dr. Califf to discuss the FDA’s alleged failures to keep drug prices down.

“We have … investigated the FDA’s failure to prepare for and adequately respond to drug shortages for essential medications used to treat infection, heart disease, and cancer, just to name a few examples,” Mr. Comer said during the hearing.

Mr. Comer urged the FDA to work with multiple federal agencies, including the Drug Enforcement Administration, Department of Justice, and Department of Defense, to increase drug production.

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