AFP, April 15 (Editor: Xiaoxiang) The US now seems to be facing an unprecedented “drug shortage”...

According to data from the American Association of Health System Pharmacists (ASHP) and the Utah Drug Information Service, in the first three months of 2024, there was a shortage of 323 drugs across the US. This is the highest level since ASHP began tracking the survey in 2001, and surpassed the shortage of 320 drugs in 2014.

According to the above statistics, the supply of everything from first aid injections to diabetes medicines is tight.

The drugs affected include the widely used diabetes drugs Ozempic and Mounjaro, the allergy medication adrenaline, the common antibiotic amoxicillin used in children, chemotherapy drugs, and injections commonly used in hospitals in intensive care.

Paul Abramowitz, CEO of ASHP, said in a statement, “Almost every class of drugs is prone to shortages. “Some of the most worrying shortages relate to generic sterile injectable drugs, including cancer chemotherapy drugs and emergency medicine stored in hospital ambulances and operating areas.”

Last year, the American Cancer Society issued a warning that chemotherapy drugs had returned to the list of the five drugs most affected by the shortage, and warned that this could have a devastating impact on patients.

Some hospitals and clinics have reported that they don't have any chemotherapy drugs at all. Doctors have to distribute anti-cancer drugs or divert patients.

Abramowitz also said there is a continuing shortage of attention-deficit/hyperactivity disorder (ADHD) medications across the US, which remains “an issue facing clinicians and patients.”

This includes Adderall (Adderall), a prescription medication for ADHD. The shortage of the drug began in late 2022 and was initially due to a delay in delivery by one manufacturer. Today's shortages are already driven by demand as of early 2024, according to the US Food and Drug Administration.

The shortage of Eli Lilly's diabetes drug Mounjaro is also extremely serious due to being labeled a magic drug for weight loss. American patient Stan Brady usually requires Mounjaro to avoid complications that may result from uncontrolled blood sugar levels. But now, due to a shortage, his doctor had to switch him to another diabetes medication.

But Brady said that until now, the drug has not been as effective in controlling blood sugar as Mounjaro. Brady said, “It's just incredible that you can't find this medicine, and nobody seems to be doing anything about it.”

In response, Eli Lilly said that an “unprecedented surge in demand” for Mounjaro and its similar drug, Zepbound, limited their supply. The company also discovered that an older diabetes drug, Trulicity, was also experiencing supply disruptions. The company said, “We are aware that this situation may disrupt people's treatment plans, so we are working with a sense of purpose and urgency to address this issue.”

Eli Lilly is investing in production and supply capacity to increase Mounjaro and Zepbound production in the second half of 2024. The company said it expects intermittent supply disruptions in the near future due to unprecedented demand.

According to people in the US medical industry, many of the drugs currently in short supply are actually generic drugs. Drug shortages mean that some patients have to go to multiple pharmacies to find medicines, wait longer to receive critical treatments, or are forced to take alternatives. However, once you really can't find a generic drug, you will need to pay more to buy the original research drug. Drug shortages are also putting patients at higher risk of medication errors as hospitals have to adjust doses.

Where did America's “drug shortage” come from?

In fact, in recent years, the supply of medicines in the US has become an ongoing and growing problem. Although the shortage of some brand-name drugs (such as Ozempic and Mounjaro) is simply because their manufacturers have yet to keep up with demand, many medical and economic scholars still blame the shortage of most drugs on breakdowns in the pharmaceutical supply chain, which makes it difficult for generic drug manufacturers to profit and maintain operations.

Many generic drug manufacturers have left the industry in the past few years or have outsourced production to countries with lower labor costs, such as India. If a factory suspends production, shortages will occur and will continue — there are few suppliers to fill the gap, and it is not easy to start production of a drug, especially the sterile injections often used in hospitals, and the production process is very difficult.

In March of last year, due to a severe shortage of the anti-cancer drug cisplatin, the FDA even had to seek help from the Chinese pharmaceutical company Qilu Pharmaceutical.

Pharmacist Erin Fox, who is responsible for drug shortage data collection at the University of Utah, said, “We haven't been able to see how many shortages have been solved. For many drugs, there's probably only one or two suppliers, so when you lose capacity there, there's no extra redundant productivity.”

Joel Zivot, an anesthesiologist and intensive care physician at Emory University Hospital, said he often had to replace one medication with another due to drug shortages. He notes, “This alternative approach is extremely frustrating. But it's happening every day.”

Historically, the last time an ongoing shortage of drugs in the US reached a similar peak in 2014, then abated a few years later. And since 2021, the shortage has been getting worse. Researchers and policymakers believe that a complete solution to this problem may require changes in the business model of the US pharmaceutical industry, including measures to raise the price of generic drugs so that sales can support manufacturers and attract more companies.

Earlier this month, the White House had proposed spending $3.26 billion to $511 billion over ten years to help address the shortage of medicines. The plan will include linking the portion of health insurance payments to hospitals to whether hospitals are good at buying drugs from companies that can prove the quality of drugs for a long time, not just the cheapest price. The proposal requires congressional approval and funding.

Policymakers also proposed giving the US Food and Drug Administration (FDA) more powers so that it can obtain more information about drug shortages and impending shortages — the agency currently has very little information. According to reports, the FDA currently mainly relies on calling manufacturers to ask if they can increase supply to understand the situation.

US Food and Drug Administration Director Robert Califf told the House Supervisory Committee on Thursday, “Right now, the information we get from manufacturers is very scattered. We spent a lot of time on the phone in vain.”

The American Health System Pharmacists Association stated that it is cooperating with the federal government to provide advice to the government on measures to deal with drug shortages, including Congress requiring manufacturers to be more transparent on any supply chain issues and encouraging more diversification of the supply chain.

Abramowitz said, “There is still a lot of work to be done at the federal level to fundamentally address the shortage of medicines. The American Health System Pharmacists Association will continue to regularly engage with policy makers to guide them in drafting and passing new legislation to address drug shortages, and continue to advocate for effective solutions on behalf of our members.”