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Drug shortages for the uninitiated

Updated: Oct 11, 2023

This month, my family and I were affected by two different drug shortages. First, we couldn’t fill a standing prescription for an ADHD drug that a child relies on to function at school. Then, we couldn't source a chemotherapy drug, causing a relative’s urgent cancer treatment to be delayed. These events caused me to reflect on how drug shortages are the kind of healthcare issue that are easy for non-clinicians to have only vague awareness of, until and unless they directly affect either one’s organization, or personal life.


To the extent that anyone is unclear on the details about drug shortages, it's probably because it's so easy for any one healthcare problem to be lost in the crowd. Even among drug-related problem coverage, shortages can be drowned out by the constant clamor in the arena of drug price, spend, and opaque value-chain-type problems. (Yes, shortages are currently driving up drug spending; but in the context of price, shortages are only one contributing factor among many). Drug shortages also have a particularly whack-a-mole nature; they’re constant, but also constantly shifting. Shortages do not affect all drug categories evenly, but instead crop up in different ways, and for different reasons, across different categories.


In any case: Maybe you’re personally a little fuzzy on what’s up. Or, even if you yourself get it, maybe you hold the kind of leadership role that makes it only a matter of time until a board member or colleague asks you for a simple explanation. Either way, this very short overview of the what, why, and what's being done about drug shortages is for you.


What drugs are currently in shortage?


Shortages have rolled across many different drug types in recent years. The pain points most frequently in the headlines are, currently, the shortages among drugs for cancer, ADHD, and weight loss.


However, it’s worth knowing that more drugs than these are in shortage. Take a look at the below data from a 2023 survey asking practicing pharmacy professionals where they are experiencing critical or moderate shortage. ‘Critical’ was defined in the survey as causing rationing, delay, or cancelation of treatments and procedures.


Why do drug shortages happen?


Short answer, there isn't one single cause; and, shortages across multiple different drug types have reasons that are often in common, but not always. The exact driver, or set of drivers, of the shortage at least somewhat depends on the drug in question.


Major contributing factors run the gamut from manufacturing issues to economic issues, AKA market failures, such as there not being enough of a perceived incentive for manufacturers to invest heavily enough in producing certain kinds of drugs.



What’s being done about the problem?


In the contentious world of pharmacy issues, shortages enjoy the distinction of being a universally-agreed-upon problem. However, there is no consensus about what to do about them.


Here is a short summary of some of the major avenues of improvement that different stakeholders hope will mitigate drug shortages.

  • Diversification - Manufacturers are shoring up supply chain vulnerabilities (ex: relying on a single international supplier) by diversifying their sources.

  • Collaboration - Because of the complex nature of drug supply chains, enhanced communication between stakeholders (manufactures, providers, governments, etc.) are working to recognize and resolve shortages before they reach crisis.

  • Regulation - Regulators can proactively address supply issues, through quality and compliance oversight, and have tools to mitigate the impact of shortages if they arise.

  • Prediction - Drug makers, suppliers, and providers are using data analytics to create more accurate forecasts about future supply needs in order to keep pace with demand.


Will these efforts be enough to solve the problem?


Despite the impressive array of avenues of activity around drug shortages, most experts consider these efforts to be scattershot, and insufficient in total to get to resolution.


That being the case, the common perception among our expert pharma colleagues is that legislative action may be needed to realize true improvement. Just today, STAT+ shared news that a Senate finance healthcare committee is taking up the shortage issue to try to adopt a more cohesive, bipartisan approach. Hearings will begin in November, though we will not see a package introduced until next year.


Want more on the pharmacy/drug ecosystem?

  1. Tune into our public webinar, ‘Get Current On Drug Pricing Developments,’ October 19 from 1-2 ET for a board-level overview on the issue of drug prices and suggested organization-specific strategy discussion questions. You can register for this via our public webinar series page.

  2. To help colleagues learn to ‘speak’ pharmacy and the drug ecosystem in general, ask us about our Strategy Boot Camp series. You can drop us a line about that at info@unionhealthcareinsight.com.

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