Drug Shortages, Deadly Consequences

Blog#158- 5/21/23

By Richard Davis

We live in a world that has become dependent on prescription medications. It has been that way for decades despite the fact that too many people cannot afford them. And although cost remains a major barrier, people now have to contend with worsening shortages in the supply of drugs.

There have been shortages of critical drugs in the past, but it seems as though the current shortage of life-saving drugs may be showing us how the pharmaceutical industry is driven by profit while the value of human life is marginalized. Nothing new. Not exactly a revelation.

In a May 17 New York Times piece it was noted that, “Hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns. The shortages are so acute that they are commanding the attention of the White House and Congress, which are examining the underlying causes of the faltering generic drug market, which accounts for about 90 percent of domestic prescriptions. The Biden administration has assembled a team to find long-term solutions for shoring up the pharmaceutical supply chain, at a time when the United States remains heavily reliant on medicines and drug ingredients from India and China. And in recent weeks, generic drug makers, supply-chain experts and patient advocates have appeared before lawmakers to discuss the problems. The scarcity of generic forms of chemotherapy to treat lung, breast, bladder and ovarian cancers has only heightened concerns.”

What this means in practical terms is that there are now people who have started treatment for cancer, or are about to start, but have to delay that treatment because the drug that targets their kind of cancer is not available.

I can’t imagine how horrible a situation this is for people who first have had to deal with a life-threatening diagnosis and then find out that there is a treatment to help them but their doctors and hospitals can’t get the drug because of supply problems.

Interviews with a number of pharmaceutical company spokespeople and politicians don’t shed a lot of light on the problem. The fact that generic drug manufacturers cannot make enough of a profit is a cause for some of the problem. But the industry operates mostly behind closed doors and no one can really get a grip on how to craft a solution to the current problem.

A Medscape article revealed that”… the first quarter of 2023 marked the highest number of ongoing shortages by quarter since early 2018, with 301 active shortages as of March 31. For some drugs, the problem has become chronic, as more than 15 critical drug products have been in short supply for more than a decade, and 20 have been in shortage since at least 2015.”

There have been congressional hearings and the usual expressions of outrage that we too often hear from politicians and policymakers, but the pharmaceutical industry has so much lobbying power that nothing changes while people die because a greedy industry can’t squeeze enough profit from their products.

Some so-called experts say that the market needs to be fixed but it is the market that is causing the problem. Free market capitalism may work fine for selling cars and refrigerators but it is a massive failure when it comes to pharmaceutical products.

The only way there will ever be affordable and accessible medications to keep people alive and healthy is for the government to take over the manufacture and distribution of prescription drugs. Some will argue that this kind of move will stifle research and innovation but it is the U.S. government that funds and supports most drug research already.

Others may say that the government is too inefficient to run such a big industry but the government already does a lot of the funding and work that supports an immoral industry. The average profit margin in the pharmaceutical industry runs around 30 percent.

The government is capable of operating this industry at a point slightly above break even. If you think government is inefficient and not up to the task consider the fact that the Medicare program runs with two percent administrative costs while the insurance industry’s administrative costs run from 11 to 20 percent.

Who will speak for those who are suffering and dying? What will it take before those in power really understand how critical drug shortages are?

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