The most severe "drug shortage" in history struck the United States.
According to the latest data from the American Society of Health System Pharmacists (ASHP) and the Utah Center for Drug Information Services, a total of 323 drugs in the United States were in severe shortage in the first quarter of this year, exceeding the record of 320 shortages in 2014. This is also the most severe drug shortage in the United States since the organization began tracking in 2001. According to statistics, the supply of all drugs, from emergency injections to diabetes drugs, is very tight.
Currently, the drug supply in the United States has become an ongoing and increasingly serious major issue. Scholars in the fields of healthcare and economics in the United States believe that the reason for most drug shortages in the country is the disruption of the drug supply chain.
Earlier in April this year, the White House proposed spending $3.26 billion to $5.11 billion (approximately RMB 23.6 billion to $37 billion) over the next decade to help solve the drug shortage problem in the United States.
"Drug shortage" raid
Currently, the United States seems to be facing an unprecedented "drug shortage".
According to the latest data from the American Society of Health System Pharmacists (ASHP) and the Utah Center for Drug Information Services, in the first quarter of 2024, 323 drugs in the United States were in short supply, exceeding the highest record of 320 shortages in 2014. This is also the most severe drug shortage in the United States since the organization began tracking in 2001.
According to ASHP statistics, the supply of all drugs, from emergency injections to diabetes drugs, is very tight.
The drugs affected include the widely used diabetes drugs Ozempic and Mounjaro, the allergy drug epinephrine, the common antibiotic amoxicillin for children, chemotherapy drugs and injections commonly used by hospitals in intensive care.
ASHP CEO Paul Abramowitz stated in a statement that almost all categories of drugs are facing shortages. The most concerning shortage involves non patented sterile injectable drugs, including cancer chemotherapy drugs and emergency drugs stored in hospital emergency vehicles and surgical areas.
The American Cancer Society has issued a warning that chemotherapy drugs have returned to the top five categories of drugs most affected by shortages, warning that this could have a devastating impact on patients.
Some hospitals and clinics have reported that some chemotherapy drugs have been completely depleted, and doctors have had to administer anti-cancer drugs or urgently divert patients.
Abramowitz stated that attention deficit/hyperactivity disorder (ADHD) drugs are also continuously in short supply across the United States, which is "a problem faced by clinical doctors and patients.".
This includes the prescription drug Adderall for treating ADHD. The shortage of this drug began at the end of 2022, initially due to delayed shipments from a manufacturer. According to the US Food and Drug Administration, as of early 2024, the current shortage has been driven by demand.
The shortage of popular drugs is even more serious, among which the shortage of Mounjaro, a diabetes drug known as the "magic drug for weight loss", is extremely serious.
In response, Lilly stated that the unprecedented surge in demand for Mounjaro and its similar drug Zepbound has led to a shortage in the market. The company stated that it has realized that this situation may interfere with people's treatment plans and is currently working purposefully and with a sense of urgency to address this issue.
Lilly is increasing investment to increase production of Mounjaro and Zepbound in the second half of 2024. The company stated that due to unprecedented strong demand, intermittent supply interruptions are expected in the near future.
Why did you encounter a "drug shortage"?
According to industry insiders in the United States, many of the drugs currently in short supply are actually generic drugs. Drug shortages mean that a large number of American patients must run to multiple pharmacies to find medication, wait longer for critical treatment, or be forced to accept alternative medications.
If a generic drug cannot be found, additional fees will need to be paid to purchase the original drug. The widespread shortage of drugs also puts American patients at a higher risk of medication errors.
Joel Zivot, an anesthesiologist and intensive care physician at Emory University Hospital, said that due to drug shortages, he often has to replace one drug with another.
In fact, the drug supply in the United States has become an ongoing and increasingly serious major issue.
Among them, the shortage of some popular drugs (such as Ozempic and Mounjaro) is due to the huge demand, which leads to a shortage in the market.
However, scholars in the fields of healthcare and economics in the United States believe that the reason for most drug shortages in the country is the disruption of the drug supply chain.
In recent years, many generic drug manufacturers in the United States have withdrawn or outsourced production to countries with lower labor costs such as India.
If a factory suspends production, it will cause a shortage and it will continue - there are almost no suppliers to fill the gap. Because the threshold for initiating the production of a certain drug is extremely high, especially for sterile injections commonly used in hospitals, the production process is very challenging.
For example, due to a severe shortage of the anti-cancer drug cisplatin, the US Food and Drug Administration (FDA) urgently sought help from Chinese pharmaceutical company Qilu Pharmaceutical in March last year.
Erin Fox, a pharmacist responsible for drug shortage data collection at the University of Utah, said that for many drugs, there may only be 1-2 suppliers, and once production capacity is lost, there is no additional redundant production capacity.
Urgent proposal from the White House
In American history, the last large-scale "drug shortage" occurred in 2014, and it only eased in the following years.
Since 2021, the shortage of drugs seems to be becoming increasingly severe. US researchers and decision-makers believe that to completely solve the "drug shortage", it may be necessary to change the business model of the US pharmaceutical industry, including taking measures to increase the prices of generic drugs, in order to attract more drug manufacturers.
Earlier in April this year, the White House proposed spending $3.26 billion to $5.11 billion (approximately RMB 23.6 billion to $37 billion) over the next decade to help solve the drug shortage problem in the United States.
This proposal requires approval and funding from the United States Congress.
Policy makers suggest giving the FDA more power to obtain more information about drug shortages and upcoming shortages. Currently, the FDA mainly relies on calling manufacturers to inquire if they can increase supply to understand the situation.
The American Association of Health System Pharmacists pointed out that it is working with the federal government to provide recommendations to the government on measures to address drug shortages, including Congress requiring manufacturers to be more transparent on any supply chain issues and encouraging supply chain diversification.
Abramowitz said, "There is still a lot of work for the federal government to do to fundamentally address drug shortages. The American Association of Health System Pharmacists will continue to regularly engage with policymakers, guide them in drafting and passing new legislation to address drug shortages, and continue to advocate for effective solutions on behalf of our members."