Written by: Howard Levine, Pharm.D
Just when you thought things are getting tight, they get tighter. Over the past several years there has been a growing incidence of drug shortages in the U.S. This affects patients on several levels.
First, patients who need to be treated with these drugs may not have access to them as supplies dwindle. This leads to prescribers to look for alternative treatments (if available). By definition, the alternative treatment is NOT the first choice for the patient. The alternative may be less effective and/or more troublesome for patients to tolerate.
Second, the cost of alternative treatments may be significantly different from the preferred, but unavailable, drug. This cost is often passed on to the patient and the health care system. It has been estimated that drug shortage in the U.S. cost the system almost $360 million annually in labor costs alone to manage the problem.1
Third, the disruption in supply has been associated with medication errors according to surveys of health care organizations.1
Drug shortages often occur in the less expensive, segment of the system, generic drugs. This is due to the relatively small number of generic drug manufacturers. There is a negative incentive for pharmaceutical manufacturers to produce generic drugs, as the price of these drugs is low compared with other drugs they could manufacture. Manufacturers tend to prefer production of higher priced drugs which generate more revenue rather than generic drugs.2
Drug shortages, along with the loss of manufacturer’s interest in producing generic drugs have led to increased costs for generic drugs over time due to reduced competition among manufacturers.
The system for protecting patients with regard to drug shortages is broken and needs repair. Although Congress has legislated requiring notification of impending shortages, this will not prevent the problem.
Perhaps a groundswell asking the government to take action similar to that taken for the tobacco industry, among others, to subsidize generic drug manufacture would be appropriate. This would keep costs low and ensure drug availability.