US drug shortages have reached “emergency” levels, with cancer, heart disease and transplant patients facing a lottery to get life-saving drugs.
Up to 300 drugs are currently in shortage nationwide, according to the American Society of Health-System Pharmacists, which is a five-year high.
They include everything from chemotherapy and antibiotics to a sterile fluid used to stop the heart in bypass surgery and an antidote for lead poisoning.
Experts warn that a small pool of manufacturers combined with low prices for generics and factory closures are leading the trend, along with sudden spikes in demand.
Supply chains also have yet to recover from the Covid pandemic, while the US continues to depend heavily on medicine imports from China and India. The country has also been dealing with flare-ups of strep throat and other normally benign diseases this year, sending demand for common drugs soaring.
The chart above shows the number of drugs currently in shortage according to the American Society of Health-System Pharmacists
The United States is facing a shortage of a specific type of albuterol used in nebulizer machines (stock image above of albuterol and part of a nebulizer machine)
It was revealed earlier this month that the Biden administration has quietly assembled a team to alleviate the shortage, considering plans that include tax breaks for manufacturers.
Sounding the alarm, Dr. Amanda Fader, a gynecologist at Johns Hopkins University in Maryland, told the New York Times that the situation is an emergency.
“This is, in my opinion, a public health emergency,” he said, “because of the scale of people it affects and the number of chemotherapy agents that are in shortage right now.”
Dr. William Dahut, chief medical officer of the American Cancer Society, added his voice to the calls to action.
He said: ‘If these drugs [chemotherapy] are not available, people will receive inferior care.
‘That’s the bottom line. These are not third or fourth line drugs where there are many other agents around.
“These are used upfront for the people you’re trying to treat.”
The Food and Drug Administration (FDA) currently lists more than 150 drugs as deficient on its website.
But the American Society of Health-System Pharmacists (ASHP), which tracks shortages nationwide, says there are 301 drugs that doctors are currently struggling to get hold of.
The shortage is leaving hospitals with little choice but to ration frontline treatments and offer them only to the most seriously ill patients.
Among those affected is 39-year-old pancreatic cancer patient Ryan Dwars, who lives in Iowa and has a son and daughter.
His cancer initially went into remission, but he was told late last year that scans had found cancerous spots on his liver.
The father-of-two was due to receive his last four doses of chemotherapy in April, but his doctor canceled treatment saying he was not a priority patient.
He told The New York Times: ‘The light at the end of the tunnel was in sight. It was even worse being so close and now this.”
He was eventually connected to the drugs he needed through the nonprofit Angels for Change, which works to provide shortage drugs to patients, but others haven’t been so lucky.
Others affected include James Loxley in Rhode Island who received a kidney transplant from his father 26 years ago.
He needs to take the drug cyclosporine, sold under the brand name Neoral, every day to keep his body from rejecting the organ.
Mr Loxley told WPRI that receiving the drug made him “able to live life to the fullest with that transplant” but that there was now a shortage that he was struggling to get hold of the drug putting his life in danger .
After contacting his Senator, he was able to secure an emergency supply, and it is possible that others may not have been so lucky as well.
There were problems sourcing the drug through the end of February, the pharmacies say, but they add there could still be delays getting the drug delivered to patients.
The US drug market is vulnerable due to few domestic producers, but it also has to depend heavily on imports from other countries, especially India and China.
The domestic manufacturing industry struggles due to the low price of generics, which has fallen by 50% since 2016, and lower production costs abroad.
Generic drugs are versions of more expensive brand-name drugs that are cheaper for companies to produce, but bring in less profit.
This shows the number of medicines in shortages per year since January 2001. There have been 47 reports so far in 2023, the ASHP said
The pressure led Illinois-based generics maker Akorn Pharmaceuticals to file for bankruptcy in March, closing all of its factories and laying off 900 workers.
The company had produced around 100 medicines including canisters of albuterol for children with asthma and breathing difficulties. It was also the only company in the United States to produce an antidote for lead poisoning, according to Dr. Eric Tichy, president of supply chain at the Mayo Clinic in Minnesota.
There are also problems with the supply of drugs from abroad, especially for chemotherapy drugs.
Late last year, the FDA stopped Intas Pharmaceuticals from supplying three chemotherapy drugs to the United States: methotrexate, carboplatin and cisplatin.
The move was made after investigators found a truck filled with hundreds of plastic bags filled with documents torn and shredded during an inspection.
One worker even poured acid on the forms, they added.
The decision, however, has resulted in severe shortages of drugs in the United States that patients need to treat cancers.
The problem has reached the point that now the White House and Congress are examining the causes of the crisis.
Plans under consideration include offering tax incentives for the manufacture of generic drugs and creating an agency to track overseas drug supplies to the United States, Bloomberg reports.
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