![]() Most shortages can be traced to a lack of raw materials or, most often, a problem at the manufacturing site. Every drug on the market has its own variation of this flow chart. Take a look at this graphic from the National Academies report. The producer must take those raw materials and then manufacture the drug, at a factory capable of executing a technically sophisticated production process, in the most economical fashion, while also meeting FDA safety and quality requirements. A company first has to acquire the necessary ingredients, sometimes from suppliers all over the world. Manufacturing a prescription drug is complicated. Why drug shortages happen - and their sometimes deadly consequences Until that happens, there is little reason to think the pace and duration of America’s drug shortages will slow down. But they require action by the federal government. ![]() Even short of death, drug shortages can meaningfully change the care patients get - if, for example, a pregnant person undergoes a cesarean delivery, with its higher risk of complications and longer recovery time, because the drug that could have induced labor earlier is out of stock.Įxperts do have ideas about how to make the pharmaceutical supply chain more resilient. A more recent study, following the year-long shortage of a drug used to treat septic shock, found higher mortality rates for patients who relied on a substitute. An Associated Press report in 2011 linked at least 15 deaths over the prior 15 months to drug shortages. Some of these shortages have led directly to patient deaths. But when you think about it from the hospital perspective, it’s very frustrating.” “It makes a lot of sense when you think about it from their perspective. If you’re going to sell something for a dollar a vial, there’s no incentive to invest there,” said Erin Fox, a pharmacist at the University of Utah who has studied drug shortages. “We haven’t invested in expanding the capacity our country needs. And they are usually cheap, which means the companies that manufacture them do not have a strong economic incentive to produce any excess supply. So if there is a problem at the factory of one company, there is not an easy way to scale up production to make up for a shortfall. Shortages for medicines that a patient can pick up at the pharmacy often draw the most headlines, but most of the medications that end up in short supply are generic, injectable drugs that are used in hospitals: usually, these drugs have only one or two suppliers. ![]() The reasons for shortages are generally consistent no matter the drug: either a shortage of raw materials or a problem at the plant where the drug is manufactured. The forgotten victims of the Adderall shortage.Īccording to a 2022 report from the National Academies of Sciences, Engineering, and Medicine, “on average, the number of ongoing drug shortages has been increasing and are lasting longer.” The root cause of that problem, per a report from the Food and Drug Administration, is the economics of the pharmaceutical market itself. And when I learned two months ago about shortages of Pitocin, the medication used to induce labor as well as to control bleeding from postnatal hemorrhages, Mark Turrentine, an OB-GYN at the Baylor College of Medicine, told me that these localized Pitocin shortages were “not something that happened just recently,” but had occurred repeatedly “over the past four or five years.” When Covid-19 arrived in the United States two years ago, the country was already short on the drugs necessary for people placed on ventilators. Shortages of saline, morphine, and cancer drugs have occurred in recent years. There is an ongoing shortage of Adderall. Shortages of drugs to treat all kinds of conditions are happening across the health system. Young patients with asthma who contract the respiratory syncytial virus (RSV) might need albuterol to ameliorate breathing problems, but that medication has been in short supply for months. Just in the past few weeks, there have been reported shortages of amoxicillin and Tamiflu in the midst of a surge in respiratory infections. The United States, the world’s richest country and its most important developer of pharmaceuticals, is not supposed to run out of prescription drugs.
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