Medicines shortage, how will the United States be cured?
The shortage of medicines is not just an Italian problem. The United States is facing the worst crisis in 10 years and the causes could be traced back to the race to the bottom of prices, which hides behind it an opaque supply chain and heavy dependence on imports, above all from China and India. All the details
Medicines are missing. And I'm not in Italy . In the United States, the crisis is reaching its worst peak in a decade, forcing doctors to develop alternative solutions and the Biden administration to organize a government-level response.
More than 300 drugs are in short supply, according to the American Society for Health-System Pharmacists, the most since 2014. The American Cancer Society and Dr. Amanda Fader, a professor at the Johns Hopkins School of Medicine and president of the Society of Gynecologic Oncology have declared it a “truly national public health emergency.”
The shortages are above all generics, but also chemotherapy and anticancer drugs, with serious consequences for patients.
WHY THERE IS A DRUG CRISIS IN THE UNITED STATES
Democratic Senator Gary Peters explained to the New York Times that the main causes of the current shortage of drugs are to be attributed to reasons of economic opportunity, to an opaque and not always continuous supply chain, as well as to the strong dependence on imports, above all from India and China for both medicines and their compounds.
BECAUSE IT IS DIFFERENT AND MORE SERIOUS THAN THE PREVIOUS
Similar crises are not new to the United States, but the difference compared to the previous ones, Erin Fox, an expert at the University of Utah Health who has dedicated her career to monitoring deficiencies since 2001, said in an interview with Bloomberg , "is that now c 'It's a large number of medicines that are in short supply and affecting both patients in hospitals and pharmacies, even those looking to buy simple over-the-counter painkillers like Tylenol and Advil for children.'
A report presented to the Senate at the end of March and reported by Sole24Ore , highlighted that "shortages have increased by almost 30% over the past year compared to 2021 and that the times to recover the supply are on average 18 months, with some borderline cases of even 15 years”.
GENERAL SOS
The shortage of commonly used generic drugs referred to by Fox concerns, in particular, as underlined in a recent hearing in the Chamber cited by Axios , the "race to the bottom" of prices which is holding back investment in production and forcing many pharmaceutical companies to declare bankruptcy, leaving the monopoly to a few of them. In fact, there are fears that the situation could worsen further if generic drug manufacturers reduce the range of products they produce or close down.
According to a study by the independent company Iqvia cited by the head of the Association for Accessible Medicines, David Gaugh, and reported by Sole24Ore , “although the number of generic drug manufacturers has increased, the market has consolidated around three intermediaries covering 90 % of purchases through their distribution chains, such as Red Oak Sourcing (which includes CVS Health and Cardinal Health), ClarusOne (which includes Walmart and McKesson), and Walgreens, which also has distribution agreements with AmerisourceBergen.
The "race to the bottom", however, seems to be attributable to competition from products imported from China and India, where, among other things, inspections by the Food and Drug Administration (Fda) have found hygienic deficiencies and low quality production. To which is added the now well-known problem of stop-and-go supplies both for the Covid emergency and for the war in Ukraine.
WHAT THE WHITE HOUSE IS DOING
To address the problem, the White House has created a team of experts called to find long-term solutions but the solutions, writes Axios , "could be expensive and disruptive" because "the FDA can identify problems and collaborate with manufacturers, but it lacks the skills and, in some cases, the authority to address the industry's most important economic issues”.
Cathy McMorris-Rodgers, chair of the Energy and Commerce Commission, spoke of options such as "increasing reimbursements for generic drugs and scrutinizing the business practices of pharmaceutical service providers."
Frank Pallone, the highest exponent of Democrats on energy and trade, has called for "greater transparency on the ingredients of drugs produced abroad and an expansion of reporting in case of unexpected spikes in the demand for drugs, as well as making it easier for the FDA safely extend the shelf life of critical drugs in short supply.
CROSSFIRE
Republican Scott Gottlieb, commissioner of the FDA during the Trump administration and member of the board of directors of Pfizer, instead underlined how efforts to contain the costs of the drugs included in the Inflation Reduction Act (IRA) have contributed "to underinvest in supplies safe and sustainable generics”.
"The generic business, especially for these complex drugs, these complex formulations, is not a healthy business right now," he told CBS News . There are things the government can do, but most of them will cost. We will have to look for ways to provide higher reimbursements for these hard-to-manufacture drugs."
This is a machine translation from Italian language of a post published on Start Magazine at the URL https://www.startmag.it/sanita/carenza-farmaci-come-si-cureranno-gli-stati-uniti/ on Fri, 26 May 2023 12:51:00 +0000.