323. That is how many medicines were in active shortage across the United States during the first three months of 2024, in a survey run by ASHP, the hospital pharmacists’ trade group, with the Utah Drug Information Service. The previous high was 320, set in 2014, and no quarter had topped either figure since the group began keeping records in 2001.
ASHP chief executive Paul Abramowitz pointed to where the pain is sharpest. “Some of the most worrying shortages involve generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications stored in hospital crash carts and procedural areas,” he said.
Why cheap drugs run out
Erin Fox, a pharmacy executive at University of Utah Health, explained the economics to CBS MoneyWatch. Mostly these are older generic products, and about half are injectables that are hard to make. Because the FDA treats all generics as equivalent, price is the only way to compete. That sets off a race to the bottom, she said, and companies respond by quitting production or cutting corners on quality.
The people who feel it are patients. Manufacturers make so little on these products that a shortage costs them almost nothing, Fox added. Insurers often cover only generics, which leaves families stuck when a pharmacy cannot fill the cheap version. Her advice: call the insurer and ask about coverage for brand names.
Most manufacturers gave no reason for their shortages in the quarterly findings. Experts blame demand outrunning supply, manufacturing limits and breaks in the supply of raw materials. Drug labels, meanwhile, must name only the company selling a product, not the plant that made it, a lack of transparency that Fox said the White House now also wants changed.
ADHD drugs, still scarce
Adderall, a treatment for attention deficit hyperactivity disorder, remained among the hardest products to find. It has been scarce since October 2022. The Drug Enforcement Administration had announced in the autumn that over a dozen makers meant to raise production, yet the pharmacist group found the problem persisting.
Federal agencies have tried carrots and sticks. The DEA lifted the quota for methylphenidate, a different ADHD medicine, by roughly 25%. In August, the FDA and DEA told manufacturers they had to produce up to their amphetamine quotas or hand the ingredient back so another company could use it. The FDA also approved several generic versions of Vyvanse, which the White House said could meaningfully ease supply.
The White House said it was putting $35 million into US production of the raw materials that go into sterile injectables. A paper the health department (HHS) released earlier that month put the long record of shortages down to market failures and “misaligned incentives.”
Sources
- Hundreds of drugs are in short supply around the U.S., pharmacists warn
- ASHP reports record high number of drug shortages
