The association between drug pricing and drug shortage in Saudi Arabia: a retrospective database analysis

Abstract

Background Previous studies have suggested that drug pricing could contribute to drug shortages; however, there is limited quantitative assessment of this potential causal association. This retrospective database analysis aimed to investigate the association between drug prices and drug shortage incidents in Saudi Arabia. Methods This was a retrospective database analysis study. Drugs with shortage notifications sent to the Saudi Food and Drug Authority (SFDA) between January 2017 and December 2020 were included. Each drug's foreign-to-Saudi price ratio (FTSPR) was calculated by dividing the mean international price by the Saudi price. Drugs were categorized into three groups based on their FTSPR: Group 1 (FTSPR > 1), Group 2 (FTSPR = 1), and Group 3 (FTSPR < 1). The primary outcome was the ratio of mean counts (mCR) between the three groups, with Group 3 serving as the control group. The analysis was adjusted for the measured confounders using a negative binomial regression model. Results A total of 900 drugs were included in the study, with 348 in Group 1, 345 in Group 2, and 209 in Group 3. The mean count in Group 1 was higher compared to Group 3 (mCR: 1.88; 95% confidence interval [CI] 1.24 to 2.83), while the mean counts between Group 2 and Group 3 were comparable (mCR: 1.39; 95% CI 0.92 to 2.09). Conclusions Our findings indicate an association between drug shortage incidents and higher prices of drugs outside Saudi Arabia. Further studies are needed to explore this causal relationship in different contexts.

Price increase negotiations to address drug shortages in South Korea’s national health insurance

“…According to a 2019 survey by the European Association of Hospital Pharmacists, medical professionals have identified price as a significant cause of drug shortages ( Miljković et al, 2020 ). Furthermore, research has shown that if a shortage of specific prescription drugs persists, the risk of drug prices rising along with the disruption of patient care increases ( Dave et al, 2018 ), and the risk of drug shortages increases even when domestic drug prices are significantly lower than those in foreign countries ( Alowairdhi et al, 2023 ).…”