Drug shortages reach ‘public health emergency levels’, doctors say
Drug shortages in the US have reached ’emergency’ levels, with patients with cancer, heart disease and transplants facing a lottery to get their hands on life-saving drugs.
According to the American Society of Health-System Pharmacists, there are currently up to 300 drug shortages nationwide, which is a five-year record.
They include everything from chemotherapy and antibiotics to a sterile fluid used to stop the heart in bypass surgery and an antidote to lead poisoning.
Experts warn that a small pool of manufacturers coupled with low generic drug prices and factory closures are driving the trend, alongside sudden spikes in demand.
Supply chains have also yet to recover from the Covid pandemic, while the US remains heavily dependent on drug imports from China and India. The country also experienced flare-ups of strep throat and other normally benign illnesses this year, boosting demand for common medicines.
The chart above shows the number of medications that are currently deficient according to the American Society of Health-System Pharmacists
The US is facing a shortage of a specific type of albuterol used in nebulizers (stock image above of albuterol and part of a nebulizer)
It was revealed earlier this month that the Biden administration has quietly assembled a team to alleviate the shortfall, taking into account plans that include tax breaks for manufacturers.
Dr. Amanda Fader, a gynecologist at Johns Hopkins University in Maryland, sounded the alarm New York Times the situation was an emergency.
“This, in my opinion, is a public health emergency,” she said.
“Because of the breadth of individuals it affects and the number of chemotherapy drugs that are currently in short supply.”
Dr William Dahut, the chief medical officer of the American Cancer Society, also added his voice to calls for action.
He said, ‘Like these drugs [chemotherapy] are not available, people receive inferior care.
That’s the bottom line. These are not third or fourth line drugs where there are multiple other agents around.
“These are pre-used for people you’re trying to heal.”
The Food and Drug Administration (FDA) currently lists more than 150 medications as deficient on its website.
But the American Society of Health-System Pharmacists (ASHP), which monitors shortages nationwide, says there are currently 301 drugs that doctors are struggling to get their hands on.
The shortage has left hospitals with little choice but to ration first-line treatments and offer them only to the most seriously ill patients.
Among those affected is 39-year-old pancreatic cancer patient Ryan Dwars, who lives in Iowa and has a son and daughter.
His cancer initially went into remission, but late last year he was told scans had picked up cancerous spots on his liver.
The father-of-two was due to receive his final four doses of chemotherapy in April, but his doctor canceled the care, saying he was not a priority patient.
He told the New York Times, “The light at the end of the tunnel was in sight. It made it worse to be so close – and now this.’
He was eventually linked to the drugs he needed through the non-profit organization Angels for Change, which works to get medicines to patients in need, but others haven’t been so lucky.
The US drug market is fragile because there are few domestic manufacturers and at the same time it is heavily dependent on imports from other countries, especially India and China.
The domestic manufacturing industry is struggling because of the low price of generic medicines, which have fallen by 50 percent since 2016, and lower production costs abroad.
Generic drugs are versions of more expensive brand-name drugs that are cheaper for companies to make but generate less profit.
This shows the number of drug shortages each year since January 2001. There have been 47 reports so far by 2023, the ASHP said
The pressure led Illinois-based generic manufacturer Akorn Pharmaceuticals to file for bankruptcy in March, closing all of its plants and laying off 900 workers.
The company had made about 100 medicines, including cylinders of albuterol for children with asthma and breathing difficulties. It was also the only company in the US to make an antidote for lead poisoning, according to Dr. Eric Tichy, president of supply chain at the Mayo Clinic in Minnesota.
There have also been problems with the supply of medicines from abroad, particularly for chemotherapy medicines.
Late last year, the FDA stopped India-based Intas Pharmaceuticals from supplying three chemotherapy drugs to the US: methotrexate, carboplatin and cisplatin.
The move was made after investigators found a truck full of hundreds of plastic bags full of torn and shredded documents during an inspection.
One worker even poured acid on the forms, they added.
However, the decision has led to major shortages of drugs in the US that patients need to treat cancer.
The problem has gotten to the point where the White House and Congress are now investigating the causes of the crisis.
Plans under consideration include offering tax breaks for generic drug production and setting up an agency to monitor the supply of drugs from abroad to the US, reports Bloomberg.