Pharmacists are sounding the alarm as drug shortages in the United States have reached an unprecedented level.
According to the American Society of Health-System Pharmacists (ASHP) and Utah Drug Information Service, there were 323 active medication shortages during the first three months of 2024. This surpasses the previous record high of 320 shortages in 2014.
The tracking of shortages by ASHP began in 2001.
According to Dr. Paul Abramowitz, CEO of ASHP, all drug classes are at risk of experiencing shortages. He particularly highlights the concern over shortages of generic sterile injectable medications, which include crucial drugs for cancer chemotherapy and emergency situations stored in hospital crash carts and procedural areas.
The American Cancer Society issued a warning last year, highlighting the reemergence of chemotherapy drugs on the list of the top-five drug classes affected by shortages. They expressed concern about the potential devastating impact this could have on patients.
Hospitals and clinics have reported running out of medications, leaving doctors with the difficult decision of either rationing cancer drugs or prioritizing which patients receive them first.
According to Abramowitz, there is a continuous shortage of medications for Attention-Deficit/Hyperactivity Disorder (ADHD) at the national level, which poses a challenge for both clinicians and patients.
The shortage of ADHD prescription drug Adderall, which first began in late 2022 due to a manufacturer delay, is now primarily driven by high demand, as reported by the U.S. Food and Drug Administration in early 2024.
According to a statement from an FDA official earlier this year, the FDA has various tools at its disposal to help manufacturers increase supply during a shortage. This includes expediting the review of a supplement to add more active ingredients or capacity. However, specific actions cannot be shared as they are classified as commercial confidential information.
According to a report by the Senate Homeland Security Committee in March 2023, the United States has been facing shortages of certain drugs for over a decade. The COVID-19 pandemic has only worsened this ongoing problem. The report states that due to the lack of necessary medication, patients are experiencing delays in receiving treatment, having to resort to substitutions, or even going without treatment altogether.
During a hearing held by the House Ways and Means Committee earlier this year, a panel of expert witnesses comprised of practitioners, researchers, and pharmaceutical company executives emphasized the financial burden that drug shortages can place on patients. They explained that when faced with a shortage, patients often resort to purchasing alternative products, which can come with a higher price tag.
The American Society of Health-System Pharmacists (ASHP) is collaborating with the federal government to provide guidance to Health and Human Services (HHS) agencies regarding shortages. ASHP is actively suggesting measures that the federal government can implement to address these shortages effectively. Some of the recommendations include enforcing transparency from manufacturers regarding supply chain issues and promoting diversity in the supply chain. ASHP believes that these steps can help alleviate the shortage and ensure a more stable supply of medications.
The U.S. Department of Health & Human Services has proposed a plan that could penalize hospitals for not having enough resources to stockpile medications. ASHP, on the other hand, has expressed concerns regarding this proposal.
According to Abramowitz, there is still a lot of work that needs to be done at the federal level in order to address the underlying issues causing drug shortages. He emphasized that ASHP will remain actively involved in discussions with policymakers, as they work towards developing and implementing new legislation to tackle this problem. Additionally, Abramowitz highlighted the organization’s commitment to strongly advocating for effective solutions that benefit their members.