Drug shortages can cause serious dilemmas for providers, whether it’s having to prescribe a more expensive drug or make tough calls on which patients can even access medication. In recent months, the shortages have only gotten worse.
The number of active, ongoing drug shortages in the US is at its highest level in nearly a decade, according to data from the American Society of Health-System Pharmacists (ASHP).
“It’s not necessarily that we’re having a huge influx in the number of new shortages, but the shortages that we have are not resolving,” Erin Fox, associate chief pharmacy officer of shared services at the University of Utah Health in Salt Lake City, told Healthcare Brew.
Fox said “it’s not exactly clear” why so many shortages aren’t resolving, but her “best hypothesis” would be a lack of financial incentives for drug manufacturers to boost production.
The most common reasons for drug shortages are quality concerns, financial incentives, and increased demand.
But, “we learn new things about why shortages occur each time we have one,” said Stephen Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota.
A closer look at the numbers: There are 309 active, ongoing drug shortages in the US as of the end of the first half of 2023. That’s the highest it’s been since mid-2014, when there were 320 drugs in shortage, ASHP data shows.
Most of these drugs have been in shortage for multiple years. Only 88 new drugs have gone into shortage in 2023, which is actually pretty low compared with recent years.
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What types of drugs are most affected? The drug classes with the most shortages include antibiotics, central nervous system medications, and chemotherapy drugs, according to ASHP.
The majority of drugs in shortage are injectables, but Schondelmeyer said the US is “seeing more and more shortages among oral medications used in the outpatient market,” like amoxicillin.
Amoxicillin, an oral antibiotic, has been in shortage since November 2022. Pharmacy staffing agency Jackson Pharmacy Professionals conducted a survey in February that found 73% of pharmacists said they lacked amoxicillin in their workplace within 45 days leading up to the survey.
There are also a number of chemotherapy drugs in shortage in the US.
Michael Ganio, senior director of pharmacy practice and quality at the ASHP, said there are roughly 20 chemo drugs in shortage. Two of those shortages are so severe that the FDA has started to import the drugs from Canada and China, according to the University of Minnesota’s Center for Infectious Disease Research and Policy.
The chemotherapy drugs in shortage are “often without alternatives,” according to ASHP, meaning there are no other drugs available that have the same clinical effect as the one in shortage.
“That can mean difficult ethical decisions about which patients are being treated,” Ganio said. “Unlike a lot of other drugs, it’s not easy to just switch between drugs in that class. Blood pressure medication goes into shortage? OK, I’ll switch you to another drug in the class or to a different class. Not as much of a big deal as chemotherapy.”