Drug shortages in America have reached a record high, impacting millions of patients. Shortages can have life-threatening consequences. As medicines like chemotherapy agents run short, doctors must make difficult choices. Hospitals are spending millions to address the problem.
It’s important for policymakers to act to make our nation’s drug supply more dependable in the long term. And they must tackle the problem of the current shortages.
At Kaiser Permanente, we take a particular interest in this problem as we prescribe drugs, fulfill prescriptions in our pharmacies, and provide prescription drug coverage. We have worked hard to find solutions for our patients, and we support policies that maintain access to critical drugs and improve care and affordability.
Like many industries, drug manufacturing often uses a “just-in-time” manufacturing process. This helps avoid surplus supply and improves efficiency. However, it results in less flexibility, especially when there is greater demand or a problem with production.
Key materials needed for drug production often come from a small number of sources. If ingredients come from a specific region or a handful of suppliers, one problem can threaten manufacturing and disrupt supply. For example, damage from a tornado that struck a Pfizer plant threatened the production of virtually the entire national supply of sterile injectables.
Unfortunately, organizations that buy drugs in bulk for patients often have little visibility into the full drug supply chain. They can’t see what happens at each stage of the manufacturing process. If there’s a problem, they won’t know and can’t prepare for a coming shortage.
Changes in the generic drug industry pose challenges too. Generic drugs, which are less expensive alternatives to brand-name drugs with no difference in quality, safety, and efficacy, make up the bulk of medications dispensed in the U.S. The generic drug industry operates on thin profit margins. This deters many generic manufacturers from investing in expensive, advanced manufacturing processes. In the past 25 years, many generic drug production lines in the U.S. have closed, making it harder for Kaiser Permanente and other customers to have a stable supply of the generic drugs we need to lower costs and ensure access.
Finally, consumer demand for specific drugs like ADHD medication has increased. Often, manufacturers don’t anticipate this and can’t ramp up production.
To help ensure high-quality care at Kaiser Permanente, we take proactive steps to address drug shortages. We routinely buy a “buffer” or safety stock of critical medications. We do our best to analyze data from our suppliers to anticipate supply challenges and conserve existing supplies when necessary. We also support newer nonprofit manufacturing organizations, like Civica Rx, that make quality generic drugs in the U.S. and have a mission to keep them affordable. Our efforts alone aren’t enough — we need policy leaders to act too.
Congressional proposals addressing these issues are a promising first step. This must remain high on lawmakers’ long list of priorities, and they must act with urgency. No patient should have to worry about the supply of their life-saving drugs. Everyone deserves access to reliable, safe, high-quality medication they can afford.