amna: The U.S. Is in the midst
of an ongoing prescription drug
shortage, with more medications
in short supply for longer
stretches of time.
Laura barron-lopez has more on
what's behind it all.
Laura: Amna, drug shortages in
the U.S. Are the highest they've
been in the last nine years.
Based on the most recent data,
drug shortages increased by
approximately 30% between 2021
and 2022.
Medications currently in short
supply include chemotherapy
drugs, antibiotics, ADHD
medication like adderall, and
other critical drugs used to
treat a variety of conditions.
It's a reality making treatment
decisions difficult for doctors
and patients.
Erin fox is tracking these
shortages.
She's a national expert on drug
shortages at the university of
Utah.
Erin, thank you so much for
joining us.
Can you help us understand what
is happening here?
How severe the current drug
shortages are, and how many
drugs are actually in short
supply?
Erin: So I think when people
think of a shortage, you think
of something that is completely
100% out, and that's not the
case with the drug shortages
that we have right now.
You can usually get some, but
it's not enough.
And so that means that some
patients are getting rationed
care.
Some patients are able to access
medicines and others aren't.
And so that's a really
frustrating situation right now.
Laura: Out of the drugs that are
in short supply, which ones are
having the most detrimental
impact on patients?
Erin: I think the most
frustrating and the most
detrimental to patient care, the
chemotherapy shortages.
We just don't have alternatives
for these agents, and you know,
it's one thing to have cancer
and be struggling with that, but
then to add on the fear that
your treatment will not be
available or you may get a lower
dose, or your treatment just may
be delayed in some way.
That's really frustrating.
So I think those are probably
the most impact when we have
right now.
Laura: And what is actually
causing these shortages.
Is it manufacturing?
Is it competition with China?
Labor shortages?
What exactly is creating this
situation?
Erin:: That's a good question.
In a lot of cases, we don't know
the true root cause of many of
these shortages.
Drug companies are allowed to
keep that a secret.
But we do know from fda's data
that most of the time it's a
manufacturing problem, quality
issue at the factory, and that's
exactly what's happening with
the chemotherapy shortages.
There was a factory in India
that had some really severe
quality problems last December.
They had to close to fix those.
Unfortunately, the other
companies can't make up the
difference, and really, have an
uninterrupted supply.
Laura: Transparency is something
that some lawmakers in congress
are hoping to address.
They want to pass legislation
specifically to fix that
chemotherapy drug shortage that
you're talking about.
Though it's unclear if there are
actually enough votes currently
to get that done.
One of the measures in
particular would grant the fda
new authorory to require drug
makers to alert them if there's
demands in certain drugs amongst
the population.
Would a measure like that
actually fix this problem?
Erin: You probably wouldn't fix
the chemotherapy shortage
problem because fda knew that
there is a manufacturing problem
already.
But the demand shortages that we
saw for things like children's
pain relievers, the amoxicillin
shortage, some common antibiotic
shortatas that we've seen over
last winter, that really would
help.
In those cases, we did have big
spikes in demand, fda was not
aware.
So fda couldn't use their usual
toolkit that they have to try to
prevent those shortages from
happening without that extra
awareness.
So yes, I do think that would be
helpful.
Laura: Beyond that, if you could
wave a wand and transform this
drug supply system that we have/
what specifically needs to
change to make sure that
shortages like this don't happen
again?
Erin: You know, right now, with
many of these products, the only
competition point, but between
these generic products that are
pretty low cost and low margin
is price.
And so we've had a race to the
bottom, and sometimes that
creates an incentive to cut
corners on quality.
And so, what we need are
measures that would allow these
companies to compete more on
quality, their ability to
supply, their ability to have
redundancy in their supply
chains.
Those things could allow them to
perhaps charge a little bit of a
higher price, and then you know,
it's worth it for hospitals to
pay a little bit extra if they
know they're going to have an
assured supply of a higher
quality product.
And so we just really need to
get away from this pass/fail
system that fda has set up where
the only competition point is
price and let's look a little
bit further onto quality
measures.
Laura: Erin, is there anything
that the Biden administration
could do through executive
action, as we were just talking
about, because of the fact that
congress appears not settled at
all on legislation?
Erin: You know, I think back to
the Obama administration and
some of the executive actions
they took.
They did require a notification
rule.
At that time, there was no
notification required for
companies to tell the fda when
they were having a shortfall.
So certainly that increased in
demand notification might work
for an executive order.
But really the changes that we
need to happen are coming from
congress, coming from, you know,
perhaps CMS, and also some
public/private partnerships as
well.
Laura: That's Erin fox of the
university of Utah.
Thank you so much for your time.
Erin: Thank you so much.
♪♪