The United States continues to grapple with significant drug shortages affecting critical medications, despite a slight improvement from the record-high 323 shortages reported earlier this year. As of September 2024, 277 drugs remain in shortage, with half of these situations persisting for two years or longer.
ADHD Medication Crisis Continues
The shortage of ADHD medications, particularly affecting amphetamine-based drugs, has been ongoing since October 2022. Major manufacturers including Alvogen, Aurobindo, and SpecGx report shortages of active ingredients, while Teva faces challenges meeting increased demand. Lisdexamfetamine dimesylate, another crucial ADHD treatment, joined the FDA's Drug Shortage Database in July 2023, with multiple manufacturers reporting limited availability.
Critical Cancer Treatments in Short Supply
While the cisplatin shortage has been resolved, other essential chemotherapy drugs remain scarce. Methotrexate sodium injection, crucial for cancer treatment, has been in shortage since March 2023. Major manufacturers Accord, Pfizer, and Teva report limited availability due to active ingredient shortages and increased demand. Similarly, carboplatin injection, added to the shortage list in April 2023, faces manufacturing delays and demand-related challenges.
Insulin Availability Challenges
The insulin market has been particularly affected, with major manufacturers reporting various supply issues. Eli Lilly experienced manufacturing delays for Humalog, while Novo Nordisk reported shortages of both Fiasp and NovoLog. The situation is further complicated by Novo Nordisk's planned withdrawal of Levemir FlexPens and vials from the US market by the end of 2024.
Diabetes and Weight Loss Medications Show Promise
In a positive development, all doses of Ozempic and Wegovy (semaglutide) are now listed as "available" on the FDA's drug shortage list, though some supply variability persists at the pharmacy level. Mounjaro and Zepbound (tirzepatide) shortages have been resolved, with supply now exceeding demand.
Impact of Natural Disasters on IV Fluid Supply
Recent supply chain disruptions have extended to intravenous fluids, with Hurricane Helene affecting Baxter's manufacturing plant, which produces over 60% of large-volume IV fluids in the US. The FDA has responded by allowing temporary flexibility in compounding these essential products.
Market Dynamics and Contributing Factors
Drug shortages stem from various factors, including product-specific issues, market-wide supply constraints, and reimbursement limitations. Natural disasters, market economics, manufacturing limitations, and shifting demand patterns continue to challenge the pharmaceutical supply chain's stability.
The ongoing shortages highlight the vulnerability of the pharmaceutical supply chain and the need for robust solutions to ensure consistent access to essential medications. Healthcare providers and patients alike continue to adapt to these challenges while regulatory bodies and manufacturers work toward more permanent solutions.
