5 Takeaways From U.S. News’ ‘Solving the Crisis of Critical Drug Shortages’ Event | U.S. News Live

While news of individual drug shortages routinely make headlines, those are often just the tip of the iceberg. Today, with more than 300 drugs currently in constrained supply, shortages have reached an all-time high, according to data from the ASHP, the American Society of Health-System Pharmacists. These include medications used at hospitals to treat patients for cancer and in emergency rooms, as well as numerous prescription and over-the-counter drugs.

A panel of experts recently discussed how health care systems and providers might navigate – and potentially eliminate – drug shortages in the short and long term during a recent virtual event hosted by U.S. News & World Report.

Here are five takeaways from that conversation:

Drug Shortages Have Existed for a Long Time. They’re Just Particularly Acute Right Now.

Drug shortages are hardly a new development. For over a decade, the number of active shortages has hovered at 200, though, for the most part “this hasn’t been visible to patients,” said Tom Kraus, vice president of government relations at the ASHP, during the event.

Now at 300, including drugs such as Adderall, Hydrocodone and acetaminophen, Kraus noted that we’ve reached a “peak of shortages,” resulting in impacts for patient care and potentially a “need to ration, delay or cancel treatment” in some instances.

During the pandemic, health providers experienced something of a “pandemic paradox,” said Dr. Eric Tichy, immediate past chair of the End Drug Shortages Alliance and the division chair for supply chain management at the Mayo Clinic. In some cases, there was a drop in drug shortages, he noted, even while many kinds of medical equipment and supplies faced significant supply-chain gaps.

“We saw a little bit of a drop in drug shortages during the pandemic – some of that was because there was suspension of some of the FDA activities around investigating manufacturers,” Tichy said. However, with the end of the pandemic came a return to more rigorous inspections, bringing with them additional focus on quality issues in drug manufacturing, as well as the folding of some manufacturers.

Shortages Are Driven by More Than Just Manufacturing Issues.

While many people may assume that drug shortages are always caused by rising demand, their causes actually vary considerably.

Sure, an undue consumer demand for a drug – as in the case of popular weight-loss drugs Ozempic and Wegovy – can have an impact. But often, a shortage is the result of a manufacturing or quality issue, supply-chain troubles or simply a business decision to cut production by a pharma company, Kraus said.

Solutions Require an All-Hands on Deck Approach.

“It’s not one problem – it’s not one solution,” stressed Dr. Mittal Sutaria, senior vice president of contract and program services for Vizient, a health care performance company. (Vizient was the sponsor of the webinar.)

Several panelists provided a litany of potential ways to help, including increasing data collection on the geographic concentration of shortages, for instance, and the types of products at risk. Boosting transparency of the manufacturing and supply-chain pipeline is also important, panelists said.

“With some of these products, there technically is enough drug in the supply channel, if you will, or in the country. It doesn’t necessarily get allocated to the locations that need it. Sometimes, it’s really [a question of] who’s the quickest at making the purchases, or who has the financial wherewithal to have a stockpile,” Tichy noted.

Regardless of which tactic(s) a health system takes, all experts emphasized the need for collaboration among health care providers and drug producers to fully tackle shortages.

There Are Things That Patients and Health Providers Can Do to Help.

Making reference to her work with Vizient, Sutaria touched on the development of an essential drug list and how it might allow for both short- and long-term approach to avoiding supply issues.

Additionally, supply-chain diversity – that is, sourcing from multiple rather than just a single manufacturer for product(s) – the panel agreed, is also a key way forward to ensure availability and accessibility for providers and patients alike. Depending on a single manufacturer risks trouble should they run into issues in the production process.

It’s essential, however, not to sacrifice quality, cautioned Dr. Kenny Yu, system senior director of pharmacy services at NYU Langone Health. “We do need to keep our eye on the prize on ensuring that our supply chain is intact. But the integrity of that and the quality of how we make the products is something that we emphasize. Because if there’s a chink in the armor there, that really disrupts the whole industry.”

However, solutions aren’t solely in the hands of hospital systems and health care organizations. Panelists also encouraged patients to share their personal stories about drug shortages, as they have the potential to tip the scale with respect to legislative action, helping legislators understand the importance of the issue.

Policy Changes Can Provide a Way Forward.

While shortages aren’t necessarily caused by government action, they can be mitigated by it.

“The government can help us finance a buffer supply … providing incentives for longer-term contracts with some guarantee of supply and a penalty when that doesn’t occur,” Kraus suggested.

Panelists also briefly discussed the risks of foreign supply dependencies and the rewards of incentivizing domestic production. Kraus in particular stressed that domestic supply isn’t the be-all, end-all, as any number of circumstances – from manufacturing quality issues to even natural disasters – could disrupt drug supplies, and the industry must prepare for each possibility.