There are more active drug shortages in the United States than ever, according to data from the American Society of Health-System Pharmacists and the University of Utah Drug Information Service.
The organizations first started tracking drug shortages in 2001. Active shortages previously peaked in 2014, with 320 drugs in active shortage. Shortage levels have fluctuated in the decade since, but have been steadily trending up since 2021 — now reaching a record-high of 323 drugs in the first three months of 2024.
“It’s long past time to put an end to drug shortages,” Paul Abramowitz, chief executive officer of the American Society of Health-System Pharmacists, wrote in a blog post on Thursday.
“All drug classes are vulnerable to shortages,” he wrote. “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. Ongoing national shortages of therapies for attention-deficit/hyperactivity disorder also remain a serious challenge for clinicians and patients.”
Along with the 32 chemotherapy drugs that are in shortage, the five categories of drugs with the most shortages include central nervous system stimulants, antimicrobials, hormone agents and intravenous fluids.
The drug shortage database maintained by the American Society of Health-System Pharmacists and the University of Utah is based on voluntary reports from practitioners, patients and others that are confirmed with manufacturers. This list often includes more drugs than the number considered to be in shortage by the US Food and Drug Administration because it captures broader impacts on providers and patients.
The average drug shortage lasts about a year and a half, according to government data. More than half of the treatment shortages have persisted for more than two years, according to an analysis by health consulting firm IQVIA. And the average shortage affects at least half a million patients, many of them older adults, according to the US Health and Human Services Office of the Assistant Secretary for Planning and Evaluation, which shared its analysis with Congress in May.
Increased demand can play a role in drug shortages, as with recent shortages of weight loss drugs. But more often, manufacturing and quality problems, such as supply chain gaps and discontinuations, are at the root.
Last week, HHS published a white paper outlining policy suggestions to help prevent drug shortages and mitigate vulnerabilities. Among the key recommendations are collaborations with manufacturers and hospitals that aim to bring transparency to the drug market and incentivize investment in resilient and diverse supply chains.
But the American Society of Health-System Pharmacists has “serious concerns” about parts of this proposal, notably the financial penalties for hospitals that lack resources to comply with the recommendations.
“We all know that managing shortages isn’t enough and is not a sustainable solution to the worsening crisis,” Abramowitz wrote. “Much work remains to be done at the federal level to fix the root causes of drug shortages.”