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How should we address drug shortages?

Written by Diane Archer

It’s hard to believe, but some prescription drugs are hard to come by. A new federal report by the Food and Drug Administration (FDA) attributes these drug shortages to a combination of low profitability and a “broken” health care marketplace. The FDA’s market-based recommendations for addressing these drug shortages likely means we can expect them to continue.

These days, more than 150 prescription drugs are in short supply in the US. Both generic drugs and brand-name drugs can be hard to come by. They include anesthesia drugs such as lidocaine, palliative care drugs such as bleomycin for patients with cancer, drugs for septic shock such as norepinephrine, and vaccines. Medical supplies, such as sterile water, can also be unavailable.

To be clear, drug shortages mean treatment delays or changes in treatment regimens for patients. This can jeopardize their health. One study found that more than half of hospitals (56 percent) reported they had delayed or changed patient treatment  because of drug shortages. 

Unfortunately, the problem is not getting better. In fact, it’s getting worse. An increasing number of drugs are in short supply. Moreover, shortages of drugs tend to last longer and longer.

As unfortunate, no one is keeping good data on the issue. We need good evidence of the number of drugs unavailable at any given time and the consequences of their lack of availability. As the report says, we need to know the frequency, persistence and intensity of drug shortages if we are going to best prevent them.

Most of the 163 drugs that are hard to get are generic drugs that have been on the market for decades. But, more than 50 are brand-name drugs. The reason that about half of these drugs are so hard to get is quality-control problems where the drugs are manufactured.

The FDA report recommends that the price of these drugs go up to address the shortages. It suggests that there be quality ratings of these drugs as a possible way to help pharmaceutical companies command higher prices for them.

Notably, the authors did not recommend government intervention to ensure these drugs are available, even though some of these medications are critical for saving lives. Vincristine, for example, is a cancer drug, that treats a variety of common childhood cancers. Pfizer, which makes the drug, says it is addressing the shortage.

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