According to data from the American Society of Health-System Pharmacists and the University of Utah Drug Information Service, the United States is experiencing a surge in active drug scarcities like never before.
The organizations commenced monitoring drug scarcities in 2001. Active shortages previously peaked in 2014, with 320 drugs in active shortage. Shortage levels have fluctuated in the decade since, but have been steadily trending up since 2021 — now reaching a record-high of 323 drugs in the first three months of 2024.
“It’s long past time to put an end to drug shortages,” wrote Paul Abramowitz, chief executive officer of the American Society of Health-System Pharmacists, in a blog post on Thursday.
“All drug classes are vulnerable to shortages,” he stated. “Some of the most worrying shortages involve generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications stored in hospital crash carts and procedural areas. Ongoing national shortages of therapies for attention-deficit/hyperactivity disorder also remain a serious challenge for clinicians and patients.”
Among the 32 chemotherapy drugs experiencing scarcity, the five primary categories of drugs facing shortages comprise central nervous system stimulants, antimicrobials, hormone agents, and intravenous fluids.
The drug shortage repository overseen by the American Society of Health-System Pharmacists and the University of Utah relies on voluntary submissions from practitioners, patients, and other sources, which are subsequently verified with manufacturers. This compilation frequently encompasses a greater number of drugs than those officially recognized as in shortage by the US Food and Drug Administration, as it encompasses wider ramifications for providers and patients.
The average duration of a drug scarcity spans approximately eighteen months, as per government statistics. Analysis conducted by health consulting firm IQVIA reveals that over half of the treatment deficiencies endure for more than two years. According to the US Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, which presented its findings to Congress in May, the typical shortage impacts at least half a million patients, many of whom are elderly.
While heightened demand can contribute to drug scarcities, recent shortages of weight loss medications, for instance, other factors such as manufacturing and quality issues, including supply chain disruptions and discontinuations, are more frequently the underlying causes.
Last week, HHS released a white paper outlining policy suggestions to address drug scarcities and reduce vulnerabilities. Among the primary recommendations are partnerships with manufacturers and hospitals aimed at enhancing transparency in the drug market and encouraging investment in robust and diversified supply chains.
However, the American Society of Health-System Pharmacists has expressed "serious concerns" about certain aspects of this proposal, particularly the imposition of financial penalties on hospitals lacking the resources to comply with the recommendations.
“We all recognize that merely managing shortages is insufficient and unsustainable in addressing the escalating crisis,” Abramowitz emphasized. “Substantial federal action is still required to address the underlying causes of drug scarcities.”
