As more evidence that inflation is NOT “always and everywhere, a monetary phenomena”, another issue affecting drug prices and availability as of late involves a nearly continuous string of shortages of common drugs required by MILLIONS of people. Here are a couple of stories stemming from work done by Erica Fox and the Drug Information Service (DIS) she leads out of the University of Utah. Under Fox, DIS has tracked this issue for DECADES and the problem has gotten significantly worse in recent years.
Here’s a graph of shortages for specific drugs encountered between 2020 and 2024 per statistics collected by DIS:
How bad is the problem? It isn’t just an issue with small quantity drugs required by patients with rare forms of cancer. It isn’t just an issue with drugs that require a compounding firm to mix other drugs into specific balanced combinations for IV use. The problem affects drugs required by MILLIONS of patients where demand has been steady and highly predictable for DECADES.
So really… how bad is it? Every large hospital has staff in their internal pharmacy operations dedicated to monitoring internal inventories of crucial drugs and scrounging citywide / statewide / nationwide for additional supplies as shortages are spotted. Inevitably, not all shortages can be alleviated so doctors have to alter treatment plans and use alternates when the medication they would have used first as their “go to” isn’t available.
Anecdotally, I can vouch for this phenomena from family experience. As the story states, one of the key classes of drugs affected are injectables, which means many varieties of insulin have experienced shortages. It also affects common prescriptions for depression which, as many people know, are NOT normally amenable to being swapped out from A to B to C as supplies come and go. ANY change in dosage much less the actual drug can throw many patients completely out of a previously established “stable zone.”
The key problem here is that while work by DIS can identify that problems are occuring, drug manufacturers do not expose enough data about their processes and supply chains to explain WHY the shortages are occuring. Are they in fact “supply chain” related? If so, what is the maker doing to diversify its supply chain or fix single points of failure in its manufacturing operations? Or do these shortages reflect these manufacturers attempting to manipulate prices in the market to the detriment of patient health? In the absence of meaningful data, it’s impossible to say.
WTH