“How many of you paid $7 or $8 for coffee at Starbucks recently?” asked Michael Ganio to a roomful of attendees at the ASHP Midyear 2025 Clinical Meeting. When many hands shot up, he continued, “Now, think about a life-saving drug that we might use in an ICU. Does it make sense for your coffee to cost more than that?”
This sparked a conversation about drug shortages, particularly sterile injectables. Surprisingly, most of these drugs typically cost less than $5 each. Even though the number of active shortages is at a seven-year low, as Ganio noted, some shortages still hit hard, especially in the sterile injectable category.
Why Are There Drug Shortages?
A 2019 FDA report highlighted several key reasons for these shortages:
- Manufacturers lack motivation: Many companies don’t see financial gains in producing less popular drugs.
- Cost over quality: Pharmacies often prioritize the cheapest options, neglecting supplier reliability.
- Regulatory hurdles: Complicated rules can delay recovery after a setback.
April Giles, from the End Drug Shortages Alliance, pointed out that when manufacturers start producing a new generic sterile injectable, they often operate at a loss for years. They depend on a strong supply chain, but disruptions at any stage can create widespread shortages.
Eric Tichy, division chair of supply chain management at the Mayo Clinic, compared this situation to a prisoner’s dilemma during the COVID-19 pandemic. People hoarded items like toilet paper, worsening overall shortages. “We need better coordination,” he said, “to allocate drugs effectively where they are most needed.”
Effects on Pharmacy Practice
Drug shortages significantly impact pharmacies, increasing costs and leading to tough ethical decisions. Pharmacists often find themselves in difficult spots, having to ration medication to patients. Tichy suggested that collaboration among suppliers and pharmacies could alleviate some of these issues. By fostering transparency, pharmacists can justify paying higher prices to ensure reliability during crises.
Jesse Schafer from the Healthcare Industry Resiliency Collaborative emphasized the need for standardized practices. His organization’s resilience assessment evaluates operational capabilities and quality management. Health systems that pass this assessment receive a badge to showcase their commitment to quality and risk management. This helps patients understand which organizations are serious about maintaining care quality.
What Can Be Done?
Experts advocate for a collective approach to address these challenges. By measuring and rewarding suppliers for quality, we can change the dynamics of drug production and availability. This collaboration may hold the key to minimizing future shortages and ensuring patients receive the care they need.
In summary, while drug shortages have eased recently, the issue remains complex. Conversations among healthcare professionals highlight the importance of cooperation and quality over mere cost-saving. As we move forward, it seems critical to shift systemic behaviors to create a more resilient drug supply chain.
For more details, refer to the FDA’s 2020 report on the root causes of drug shortages here.
