The drug shortage in the US – halting vital treatment for millions of patients and killing at least 10 people – has now reached a record high, newly released data shows.
There are currently 323 medications scarcely available nationallythe highest number since 2001, when records began.
Access to these limited medications could be the difference between life and death for millions of patients who rely on antibiotics, cancer treatments, injectable diabetes medications and more.
The shortage is said to be due to a lack of financial incentives among pharmaceutical companies, because producing certain drugs does not lead to large profits.
In many cases, demand for certain medications, such as Ozempic for obesity, exceeds the already limited supply.
About one in three US hospitals said they have had to skip, delay or prescribe fewer medications to patients than necessary due to supply shortages, while up to 99 percent of pharmacists have experienced the pressure firsthand.
The American Society of Health-System Pharmacists reported that the drug shortage currently affecting the US has reached its highest level in 23 years
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Experts have been warning about vulnerabilities in the pharmaceutical supply chain for years.
Problems may include a shortage of a key ingredient harvested from abroad, an error in the shipping process, or regulatory or quality issues at the factory where the drug is made.
Natural disasters can also impact the supply of medicines reaching hospitals and pharmacies.
For example, last summer a tornado destroyed a Pfizer pharmaceutical factory in North Carolina. tearing through the warehouse in which raw materials were stored for, among other things, morphine and anesthetics.
The US has also seen huge spikes in demand for certain anti-obesity medications, hormone therapies used in gender-affirming care, and unprecedented demand for ADHD medications like Ritalin and Adderall.
The FDA’s monitoring shows that there are shortages of many life-saving cancer drugs, including cisplatin, carboplatin and methotrexate. The shortage of these medicines has been going on for more than a year.
In 2023, a survey of 27 cancer treatment centers in the US found that 93 percent experienced carboplatin deficiency, and 70 percent reported cisplatin deficiency.
For people who rely on these drugs to treat a wide range of cancers, including testicular, ovarian, bladder, lung, blood, head and neck, and cervical cancers, the shortages are frightening.
They often mean going without medications or switching to an alternative that doesn’t work as well or can cause debilitating side effects.
About 49 percent of Americans experiencing deficiency have been forced to delay or forego treatment for their condition altogether, 24 percent have suffered negative health consequences, and 32 percent have experienced mental health issues.
Abby Bray, then nine, was treated for leukemia before the hospital ran out of the medications she relies on to survive
Laura Bray, Abby’s mother, said she was afraid her child would die if she missed one treatment session
Abby Bray, 14, was diagnosed with life-threatening leukemia as a child. Her prognosis was good until the hospital ran out of medications that were keeping her alive.
Abby’s mother Laura, from Florida, was shocked when, one afternoon during Abby’s treatment, the oncologist suggested she take her daughter home – and “wait until the meds became available again.”
‘But I was worried that if she missed one session the cancer could come back,’ Laura told DailyMail.com.
The drug her daughter was denied due to shortages was the second in a series of medications – because she was allergic to the first. The next drug, called Erwinaze, was also on the national drug shortage list for years.
The family feared this meant she would miss out on medication altogether and that her daughter would ultimately survive.
The American Society of Health-System Pharmacists surveyed more than 1,000 pharmacists and 99 percent said they had trouble stocking enough medications they needed
Mrs Bray said: ‘We found the medicine and she is back up to date with the protocol, but I had a lot of questions.
‘I knew we were dealing with injustice. I knew it was a market failure. I knew that not only the supply chain, but all stakeholders, including the government, had accepted that failure as an acceptable loss.”
Also in Florida, 56-year-old Stephanie Scanlon told the newspaper New York Times that two of the three drugs used to treat her rare bone cancer were in short supply and she would have to go without.
She tried to get the drugs for months as the cancer spread from her wrist to her spine, culminating in doctors having to amputate her left hand.
And in North Carolina, 55-year-old Toni Dezomits, a Persian Gulf war veteran and stage 4 ovarian cancer patient, was told just a day before her third round of chemotherapy that one of the drugs she needed was unavailable due to shortages.
She had to choose between not taking the drug or swapping it for one with more debilitating side effects, “two suboptimal choices,” she told the BBC.
She said, “I’m worried because I know the drug I’m not getting is the drug my cancer responded really well to (the first time).”
Stephanie Scanlan, 56, struggled for months to find the cancer drugs needed to treat her rare bone cancer, which had spread to her spine. The Florida native had to have her hand amputated at the wrist (Photo courtesy of GoFundMe)
55-year-old Toni Dezomits, a veteran, had to choose between an alternative to cancer medicine with worse side effects, or no medicine at all for her recurring ovarian cancer
Counterintuitively, economists argue that the shortage is partly caused by generic drug prices already being too low.
Branded versions of medications are often much more expensive, increasing demand for cheaper generic alternatives that perform just as well.
Manufacturers of these cheaper generic drugs compete with fellow manufacturers to enter into distribution contracts with hospitals and pharmacies.
This competition leads to downward pressure on prices, which affects manufacturers’ profitability.
Michael Ganio, senior director at ASHP, said: ‘It’s been a race to the bottom. We need more transparency around quality so buyers have a reason not to chase the lowest price.”
If manufacturers make little profit, they cannot invest in quality control, drug development and manufacturing capabilities to meet demand.
David Gaugh, interim president and CEO of the Association for Accessable Medicines, said Axios: ‘The majority of generic drug shortages cannot be addressed without raising prices.’
The global unrest caused by the Covid pandemic has also affected the drug supply.
In many cases, factories that previously produced medicines had to quickly shift to pumping out masks and other protective gear for hospital workers and Paxlovid to treat Covid patients.
The Biden administration issued a plan to combat ongoing shortages last week, including pushing Congress to pass a law that rewards hospitals for purchasing from a variety of manufacturers, not just one or a few.
Last year, President Biden invoked the Cold War-era Defense Production Act, which requires private U.S. manufacturers to devote their resources to materials deemed necessary for national defense; in this case essential medicines.
He and his predecessor had previously invoked the Defense Production Act during the pandemic to force U.S. companies to shift resources to making ventilators and protective equipment.