Drug Shortages Threaten Lives in the U.S.: Senators Sound Alarm
"Imagine being faced with a decision between life and death due to a medication shortage," said Dr. Westin during a hearing before the Senate Finance Committee. This grim reality is becoming all too common for Americans as they grapple with record-breaking drug shortages.
Multiple senators shared harrowing stories of constituents who had suffered due to these shortages. For instance, the Vanderbilt Medical Center in Nashville needed over 100 staff members to handle the disruptions caused by these shortages, as Senator Blackburn recounted.
The U.S. is unique in experiencing such persistent medication shortages, a problem that has been plaguing the country for decades. According to the Senate Finance Committee's investigation, nearly 200 drugs with persistent shortages largely comprise generic medications, which are often the go-to prescription options for patients.
Cancer treatment is a significant issue, with many generics used in life-saving therapies like CAR-T cell therapy currently in shortage. One such medication, Fludarabin, is a reliable option but is currently unavailable, leaving patients and their physicians in a tough spot.
"Battling cancer is challenging enough," Westin said. "Add a drug shortage to the mix, and you're left with no options."
The Root of the Problem
Narrow profit margins make it unappealing for companies to manufacture generic drugs, which is the primary reason for their lack of availability. The market has seen an increase in the number of companies abandoning the generic drug market and discontinuing previously available medications, as stated by Senator Crapo.
The manufacture of these drugs is frequently outsourced to countries like China and India, which can lead to geopolitical issues and quality control problems, as noted by Dr. Inmaculada Hernandez, Professor of Clinical Pharmacy at the Skaggs School of Pharmacy and Pharmaceutical Sciences at UC San Diego.
Potential Solutions
The government could incentivize the purchase of medications from more reliable suppliers by implementing value-based purchasing. This strategy would encourage pharmacies and healthcare systems to invest in manufacturers with stable supply chains.
However, one major challenge lies in the fact that generic manufacturers are not required to disclose their supply chains. The Centers for Medicare and Medicaid Services, as the country's largest pharmaceutical buyer, could make decisions based on quality and supply chain reliability, not just price, to tackle this problem effectively.
One more challenge is the concentration of generic purchasing in the hands of a small group of powerful intermediaries in the healthcare industry. These intermediaries often secure contracts with manufacturers by offering incentives beyond the actual drug price. The excessive profit that accumulates within this system leaves little room for investments in critical infrastructure and quality manufacturing.
Hurricanes and tornadoes have also caused damage to pharmaceutical plants, affecting supply chains and the availability of multiple drugs. Extreme weather events and geopolitical tensions can drive up energy prices, straining the ability of pharmaceutical manufacturers to maintain consistent production levels.
Finally, surges in demand, particularly for ADHD medications following the pandemic, have put further strain on supply chains that were unprepared for this level of demand. Addressing these causes would require a combination of industry efforts and policy changes to reduce the risk of future medication shortages and ensure reliable access to essential treatments.
