Drug shortages are a persistent and serious problem in the United States, affecting patient care and health care costs. This article canvasses factors that contribute to drug shortages, such as manufacturing complexity, price, and quality inspection records. This article further proposes an early warning system and payment, contracting, and pricing innovations to mitigate drug shortages and offers data-driven recommendations to stakeholders looking to protect the supply of quality medicines.
Supply Chain DisruptionDrug shortages impede health care delivery in the United States, affecting patient care and increasing health care costs. 1,2,3 While the immediate supply chain disruptions triggered by the COVID-19 pandemic are gradually resolving, the United States continues to face persistent drug shortages. In the first quarter of 2023, US active drug shortages were at their highest levels since 2014. 4 Drug shortages trigger ethical considerations regarding equity of access, information transparency, and crisis management. How should clinicians decide which patients should have access to scarce drugs and treatment alternatives? How should drug shortage information be communicated to patients and the public in a manner that is transparent, accurate, and responsible? What are the criteria for evaluating patient demand under crisis conditions? This article quantitatively evaluates the impact of manufacturing complexity, price, and quality inspection records on drug shortages in the United States using publicly available data from government websites and the subscription-based Medicine Supply Map. By quantifying the factors correlated with drug shortages, stakeholders can make datadriven decisions to protect the supply of quality medicines, ultimately minimizing the ethical dilemmas triggered by drug shortages. Based on our findings, we advocate for the implementation of 2 strategic solutions aimed at fortifying the resilience of pharmaceutical supply chains: (1) investment in an early warning system for drug shortages and (2) exploration of payment, contracting, and pricing innovations Citation