Thousands of people across the United States are struggling to get their prescriptions filled as the country faces record-high drug shortages. There are shortages of critical medications, including some to treat bacterial infections, mental health conditions, and even cancer.
In a March report, the Senate Homeland Security and Governmental Affairs Committee deemed the situation a “national security risk.” The report adds that new drug shortages increased by almost 30 percent between 2021 and 2022 and that there were 295 active drug shortages in late 2022—a five-year high. The shortages are not only increasing but also lasting longer and impacting patients, it adds.
“It’s something that I’ve seen from time to time since I started practice about 20 years ago, but it’s gotten worse in the last few years,” says Dr. Peter Chin-Hong, an infectious disease doctor and professor at the University of California, San Francisco.
“And we generally have to substitute drugs, particularly antibiotics, for things that are not available,” he adds. “So instead of one drug, we might have to use three drugs. And every time you use a drug—an additional drug—you introduce the possibility of more side effects and drug interactions and errors.”
Read on to find out more about the current drug shortage crisis, including what to do if you’re having trouble getting your prescription filled.
Why is the U.S. experiencing so many drug shortages?
There are four main reasons why we’re seeing so many drugs in short supply: increased demand for certain drugs, overreliance on foreign supply, poor visibility of the supply chain, and low profit margin—which refers to the cost to produce certain drugs.
Increased demand has caused shortages of drugs like Ozempic, a diabetes medication that is being widely used off-label for weight loss. Another shortage happened over the winter, when we experienced a “tripledemic” that resulted in people exhausting supplies of antibiotics and over-the-counter medications like Tylenol and ibuprofen.
In addition, according to the Senate report, the U.S. is overrelying on manufacturers and raw materials in foreign countries like China and India to produce critical medications.
“It’s estimated that 90 to 95 percent of supplies for intravenous drugs are obtained from China and India,” Chin-Hong says. “So we’re putting all our eggs in one basket.”
For example, issues at one plant in India that produced about 50 percent of the U.S. supply of the chemotherapy drug cisplatin led to a shortage of the medication. In turn, the shortage of that one chemotherapy drug triggered the shortage of another similar drug, carboplatin, which substitutes cisplatin.
“During the COVID pandemic, the FDA was not doing overseas inspections of manufacturing facilities,” says Eric Tichy, board chair of the End Drug Shortages Alliance and division chair of supply chain management at Mayo Clinic. “They resumed those in the later part of 2022, and some of the actions that they had taken against manufacturers are starting to ripple through the supply chain.”
According to Chin-Hong, low visibility of the supply chain means that the government can’t intervene or raise a red flag when a drug is in short supply before it happens. In many cases of drug shortages, he says that “unless it’s something stockpiled nationally, [they’re] not really monitored unless there’s a problem like a contamination.”
“Many of these drugs that are in short supply are generic, like penicillin—that goes on such short supply sometimes—and amoxicillin,” Chin-Hong says. “That’s because there’s probably a low profit margin in Big Pharma in maintaining robust supply.”
What can be done?
There are many possible solutions to the above problems, according to Chin-Hong. Some of the most important ones include:
- Making sure that there is enough supply of essential medications to meet the increased demand.
- Diversifying the countries where we get raw materials and where drugs are manufactured.
- Improving transparency and visibility of supply chain issues by creating a system where pharmaceutical companies can report anticipated shortages.
- Incentivizing companies to maintain a good supply of certain essential drugs.
What kinds of drugs are currently in short supply?
There are shortages of a wide range of medications, including cisplatin to treat cancer, Adderall to treat ADHD and narcolepsy, Ozempic to treat diabetes, and amoxicillin for infections. To stay informed about the specific drugs undergoing a shortage, talk to your doctor and check out the American Society of Health-System Pharmacists’s drug shortages database.
What should I do if a medication I take is in short supply?
Chin-Hong suggests first talking to your health care provider and asking if you can substitute the medication you’re having trouble finding. Then, try checking if the alternative medication is covered by your insurance and if there’s a copay. Finally, even if there’s not a current shortage of the medication you take, it’s important to have a conversation with your provider about what would happen if a future shortage of the drug occurs and the possible alternatives.