Shortages of drugs like Adderall are growing in the United States, and experts see no clear path to solving them. It can mean annoyance.
Unexpected surges in demand, manufacturing issues and raw material supply shortages have been stressing patients, parents and doctors in recent months. Several factors contribute to the shortage of some medicines, such as stimulants that treat ADHD, making it difficult to predict when they will end.
In particular, the shortage of generic drugs has been a long-standing problem. The industry is consolidating, and some manufacturers have little incentive to fix the shortage, as cheap generics make marginal profits.
Here we take a closer look at this issue.
How long are medicines in short supply?
By the first quarter of this year, there were 301 nationwide drug shortages, according to the University of Utah Drug Information Service. That’s 49% higher than the 202 recorded in his first three months of 2018.
According to Professor Steven Schondelmeyer of the University of Minnesota School of Pharmacy, patients do not feel they are short of all drugs. This is because the doctor may be able to substitute another drug, and other parts of the drug delivery system are masking the problem.
“But now the shortages are increasing and they are becoming more visible,” he said.
Which medicine are you missing?
In the fall, the U.S. Food and Drug Administration announced a shortage Discontinuation of Adderall, a drug for attention-deficit/hyperactivity disorder, due to manufacturing problems. It has persisted and sometimes grown to include other stimulants to treat the condition.
The situation appears to be improving, said Erin Fox, a health researcher at the University of Utah. increase.
The FDA is also tracking a shortage of the diabetes drug Ozempic, which doctors prescribe for weight loss.Ozempic prescriptions, promoted by celebrities and others on social media, have doubled since the summer of 2021 to more than 1.2 million, according to health data firm IQVIA.
A spokeswoman for Ozempic maker Novo Nordisk said all doses of the drug are now available in pharmacies nationwide.
Last year, a surge in respiratory illnesses forced drugstore chains to temporarily limit purchases of fever reducers for children.A shortage of the antibiotic amoxicillin also occurred around that time.
Injectable drugs, such as intravenous saline and some cancer drugs used in hospitals and clinics, are more than twice as likely to be in short supply as tablets and topical treatments, one researcher said. I’m here. Recent reports Written by Senator Gary Peters (D-Mich.), Chairman of the Senate Committee on Homeland Security and Government Affairs.
Why Do Drug Shortages Occur?
The reasons are many and many factors combine to cause many shortages.
Adderall’s manufacturing problems arose as more people started taking the drug.
Prescriptions increased during the pandemic as regulators began allowing doctors to prescribe drugs without meeting patients in person first. Prescriptions for Adderall and its generics surged 20% between February 2020 and the end of last year, according to IQVIA.
As demand surges, Adderall’s supply faces additional challenges. Federal regulators restrict the supply of this drug each year because it is a controlled substance.
For some drugs, pricing can also be a factor.
Ozempic is a diabetes drug. The same drug, semaglutide, is marketed under a different brand name, Wegovy, for weight loss. Schondelmeyer noted that Wegovy’s price per milligram could be more than double that of Ozempic’s.
“People don’t want to spend that much on Wegovy, so they’re trying Ozempic,” Schondelmeyer said.
Allison Schneider, a spokeswoman for Novo Nordisk, said the price had nothing to do with the shortage. She tied it to a combination of demand and global supply constraints.
Another factor causing shortages is that drugs such as Adderall and Amoxicillin are marginally profitable, so companies have no incentive to manufacture and stockpile large quantities in case of shortages. said Fox.
“When a shortage starts with just-in-time production, it’s very difficult to solve it unless all the suppliers come back,” she said.
How will patients be affected by drug shortages?
Shortages can lead to delays in treatment, which can hurt patients dealing with time-sensitive conditions like cancer.
Doctors may be forced to prescribe alternative medicines that may not be effective. It can also lead to medication errors if doctors are unfamiliar with other drugs.
Patients may also run out of prescriptions or be forced to seek out pharmacies with sufficient supplies to refill them.
future outlook
It is difficult to predict when many shortages will be resolved, partly because demand is difficult to measure.
“We can estimate a 10 percent increase in production,” said Mike Ganio, senior director of pharmacy operations and quality for the American Society of Health-System Pharmacists. “But is that enough?”
On the other hand, conditions still exist to compensate for future shortages. The Senate report cited overreliance on foreign sources of information as a concern.
Factories in China and India supply most of the raw materials used in American pharmaceuticals. Early in the COVID-19 pandemic, India restricted the export of 13 active pharmaceutical ingredients and finished drugs made from those chemicals in order to protect the domestic drug supply.
When shortages occur, they can last for years. Also, it can be difficult for patients to obtain reliable information. Fox said there is no legal requirement for drug companies to update their public information.
The Senate report notes that “no federal agency or private industry partner has end-to-end visibility of the entire U.S. drug supply chain.”
Fox says the shortage of methamphetamine has been particularly frustrating. He said he didn’t use it.
“There was a lot of finger pointing,” said Fox.
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The Associated Press’ Health Sciences Division is supported by the Scientific and Educational Media Group at the Howard Hughes Medical Institute. AP is solely responsible for all content.
