US Pharmacists cite highest number of drug shortages since 2001

In the first three months of 2024, there were 323 active drug shortages, the highest number since 2001, according to research by the University of Utah Drug Information Service.
The drug shortage data, collected quarterly, is generated from reports from health-care professionals, most of them pharmacists at hospitals and health systems, said Erin Fox, the lead researcher and the Drug Information Service’s director

Researchers follow up by contacting drug companies to verify that a shortage exists, and if so, why and how long it’s expected to last, Fox added. The American Society of Health-System Pharmacists, in turn, publishes the findings on its website, ashp.org.
The Drug Information Service’s definition of a drug shortage is broader than the one used by the Food and Drug Administration, so the Utah shortage numbers are generally larger than the FDA’s. For example, if a drugstore had the adult-strength over-the-counter medicine, but no children’s version of the same drug, the Utah researchers would call that a shortage but the FDA might not, Fox said.
The drugs in short supply include chemotherapy agents, antibiotics, medications for attention-deficit/hyperactivity disorder and pain medications. There are also shortages of medications used in hospital crash carts, the self-contained mobile units in hospitals used to perform lifesaving interventions during cardiac or respiratory arrest.

The data the Utah researchers collect, usually based on direct contact with drug companies, suggests that problems with manufacturing or supply-chain difficulties are the most commonly cited reason for shortages.
This article is part of The Post’s “Big Number” series, which takes a brief look at the statistical aspect of health issues. Additional information and relevant research are available through the hyperlinks

https://archive.li/5WujT

https://www.msn.com/en-us/health/other/ar-BB1nWxDA

Apparently is in uk too

The number of warnings drug companies have issued about impending supply problems for certain products has more than doubled from 648 in 2020 to 1,634 last year

https://www.google.com/amp/s/amp.theguardian.com/science/2024/apr/18/drug-shortages-normal-in-uk-made-worse-by-brexit-report-warns

But I can't find the list and on various sites goes from 40 to 160 to whatever guardian here says anyone knows how to search uk healthcare system to figure it out?

 

[Dr. Ricearoni]

.
PL I'm not even sure how all these people get prescriptions for amphetamine derivatives because methylphenidate is the first line stimulant for ADHD treatment and it helped me enough.

Allow me to shed some insight in how it happens with some power leveling of my own. My mom was a drug addict munchy by proxy and I was her victim, so I had a firsthand view into how it escalates.

"My son has trouble focusing in class can we get him on something"
"It's not strong enough can we up it"
"This alone isn't cutting it we need something more"
"He's literally retarded and unmanageable we need more"

I stopped taking it altogether and the pills kept disappearing and getting refilled and upped and prescribed. It's really as simple as lying about how bad it is.

 

[OrionBalls]

Does anyone know if/why there is an Albuterol shortage? It's like pulling teeth to get an inhaler, these days.

 

[Prokhor Zakharov]

During covid many people abused the sudden proliferation of telehealth providers and insurance-covered telehealth apps to get scripts for stimulants they wouldn't have gotten otherwise. Now everyone and their mother has ADHD (read: selling the scripts to international students or abusing adderall to fix their chronic malaise), so people who have actual problems can't get the medication they need to be functional instead of spaztastic.

PL I'm not even sure how all these people get prescriptions for amphetamine derivatives because methylphenidate is the first line stimulant for ADHD treatment and it helped me enough. Primary care would rather not give you amphetamine, they will give you infinite ritalin first. I believe these "people" in large part just want the drugs and specifically the amphetamine based ones. What people who actually have had ADHD since childhood need are the disability accommodations for schools/standardized testing (ex. time and a half on the SAT) and that test is nearly always out of pocket to the tune of thousands of dollars.

The people that make the various ADHD medications are also at fault in this situation. They said they needed the DEA to allow them to make more of it (since there is a quota system set by the DEA which prevents them from making more than they are allocated) but when the DEA did a detailed audit they found that each of the manufacturers hadn't made their full allocation of medication to start with. On average they were only using 70% of their allocation. As a result the DEA said "Fuck you, we aren't giving you anymore to use when you are only using 70%. Use all of it, then bitch at us" However, despite being told this they once again in 2023 only managed to make 70% again. Everyone from Congress to the DEA to the ASPH is trying to figure out why the fuck they aren't maxing out production, and the manufacturers don't really have a good answer other than "Duh".

 

[Larry David's Opera Cape]

Does anyone know if/why there is an Albuterol shortage? It's like pulling teeth to get an inhaler, these days.

They had to change the formula a few years ago to "save the ozone layer" and ever since then it has been more expensive and there have been periodic supply chain issues.

 

[Prokhor Zakharov]

Does anyone know if/why there is an Albuterol shortage? It's like pulling teeth to get an inhaler, these days.

Yes, there is one. One of the major manufactures discontinued a product line and everyone was switched to substitutions, putting a strain on the supply of other inhalers. Also there is a shortage of nebulized albuterol, so inhalers are being used as a makeshift solution. I honestly wouldn't expect this to get better in the near future, probably going to be at least 6 months. Shit is going to get real if they don't have it under control by the start of winter.

 

[OrionBalls]

They had to change the formula a few years ago to "save the ozone layer" and ever since then it has been more expensive and there have been periodic supply chain issues.

I remember when they reformulated due to the propellant. OTC inhalers (Primetime) straight up disappeared for a few years.

Yes, there is one. One of the major manufactures discontinued a product line and everyone was switched to substitutions, putting a strain on the supply of other inhalers. Also there is a shortage of nebulized albuterol, so inhalers are being used as a makeshift solution. I honestly wouldn't expect this to get better in the near future, probably going to be at least 6 months. Shit is going to get real if they don't have it under control by the start of winter.

Dang. I was thinking about getting a nebulizer as a bulky work around, lol.

Thank you, both.

 

[mister fireworks]

I have an addy script that is a ridiculous dose and I dont really take it very much anymore. I've had this shit since I was in college many, many years ago and I would sell almost all of it to pay my rent during exams. I think I'm in the unique position of being affected by the shortages but not really impacted much. I got gobs of this shit, and the way that the DEA is changing things and especially at the state level the hoops being made to jump through to get it, I would rather have a giant stockpile than find out one day its gone.

Anyway, I've had to change pharmacies a couple times since my insurance changed over the past 18 months, but other than that whenever they were out I'd just tell them to refill it when they got more, and I think the longest I had to wait was 2 weeks, with every other delay being less than 5 days. Does anybody work on the manufacturing side of these kinds of meds? i'm just assuming that because these are generic, the companies making the pills are not incentivized to cut into their production schedule where they are making more profitable patented meds, and thus, are creating a ton of work for their own operations teams (like daily meetings on how to allocate the limited supply between pharmacies) and they are just kind of waiting until demand drops because of attrition from people who have a script but, like me, dont really need it.

Thats the only thing I can think of that would cause this shortage for the adderall in particular to last over a year. In any consumer product where you're "blending" it at an industrial level, from alcohol to pills to even gasoline, manufacturing is always chasing sales. Every supply chain disruption causes a shitshow at the factories that they try to mitigate with overtime if they arent already running 24/7. and theres other levers to pull too before the absolute last resort: allocation. Allocation necessarily pisses off your customers, costs the company a ton of money to manually decide who gets what, and with enough time it gives your competitors an easy entry into your market, as long as you dont hold the IP. Very curious if anybody who actually works in the business can give more insight into the shortage of generic drugs in general.

 

[TheOtherSideofMakeBelieve]

Yeah, asthma meds have been what I've had the most trouble getting refilled. I use a fluticasone inhaler and there's been points where I've had to wait weeks to get it filled. Thankfully I'm a few months ahead on refills but I really feel it the next morning whenever I forget to use it before bed so hopefully I don't burn through my backlog waiting on refills

I don't use albuterol often to the point that I just don't refill it until my stash starts expiring but the last few inhalers I've received definitely look janky lol, you can tell they're just handing out whatever they can get their hands on

 

[mister fireworks]

Everyone from Congress to the DEA to the ASPH is trying to figure out why the fuck they aren't maxing out production, and the manufacturers don't really have a good answer other than "Duh".

Sorry to double post but I just saw your reply. Do you think these companies are just deciding to allocate more production time to better margin drugs? Or maybe the DEA rules are structured in such a way that they can only make x qty per month/qtr and they are just saying "fuck it" we arent gonna fuck up our margins/product manufacturing mix over this shit?

 

[ZipDisk]

Which albuterol line folded?

I was told that the albuterol I get (Pro air) is shit, but jailbirds get the good "blue" inhalers.

 

[Hamstirer]

ADHD drugs are constantly in short supply. Dextroamphetamine is super popular for rich college students to abuse since they think it makes them better students (spoiler: not true, and has been proven not true, but your average 19 yo Ivy Leaguer doesn't give a fuck of course). The DEA only allows a certain amount of dextro to be produced to thwart abuse, but of course if you (and your family) have billions in the bank you can get whatever you want, so shitloads of dextro gets diverted, and the few people with literal ADHD get fucked.

O yea I ran into that last summer with Adderall at my pharmacy. And then I'd try to call around to other pharmacies to see who had it in stock and Jesus you'd think I was asking heroin to give to school children. They absolutely would not tell me if it was in stock at any of the other pharmacies around, so id have to have my DR sent it to different places and hope one had it.

 

[Cheesegirl78]

Does anyone know if/why there is an Albuterol shortage? It's like pulling teeth to get an inhaler, these days.

I haven't heard of one, but my insurance stopped covering Advair, so my doctor has prescribed something else.

 

[Mob Boss Barbie]

They can't ship out stuff when there is a war. Also Israel has two major ports one which goes to the Mediterranean and one which goes to the red sea. The red sea one is closed because the houthis keep attacking any ship in the red sea regardless of flag (also it means they can't go to the suez) which means the Mediterranean one is over worked. Furthermore that port gets rocket attacked daily by Hezbollah. That's not to say that Israel is at war so many people are fighting in Gaza to find the hostages and destroy hamas.

Teva manufactures stateside. They are one of few pharmaceutical companies that make precursors for stimulants, and they've been reporting "supply chain" as a root cause for shortages since July 2021. I can't comment on the legitimacy of that, but I can stay they've been having issues since before the conflict in Israel erupted. ASHSP does list shortage reasons on the individual medication list if the manufacturer actually responds, which isn't common.

During covid many people abused the sudden proliferation of telehealth providers and insurance-covered telehealth apps to get scripts for stimulants they wouldn't have gotten otherwise. Now everyone and their mother has ADHD (read: selling the scripts to international students or abusing adderall to fix their chronic malaise), so people who have actual problems can't get the medication they need to be functional instead of spaztastic.

PL I'm not even sure how all these people get prescriptions for amphetamine derivatives because methylphenidate is the first line stimulant for ADHD treatment and it helped me enough. Primary care would rather not give you amphetamine, they will give you infinite ritalin first. I believe these "people" in large part just want the drugs and specifically the amphetamine based ones. What people who actually have had ADHD since childhood need are the disability accommodations for schools/standardized testing (ex. time and a half on the SAT) and that test is nearly always out of pocket to the tune of thousands of dollars.

I'm convinced telehealth has directly exacerbated the issue with ADHD medication shortages. Demand absolutely exploded during lockdown. I don't know about the rest of you broke-brains, but I had to go through rigorous, long-term psychiatric testing and evaluation before getting my diagnosis. It absolutely boggles my mind that someone could see a "psychologist" virtually, say they related to a meme about ADHD, found coof restrictions to be really hard, and got handed addys like they were a box of junior mints.

This is anecdotal, but I'm not sure methylphenidate is the front line choice. I would say the majority of people I know with honest-to-god ADHD are prescribed Vyvanse, with a small handful on Adderall, maybe one person on Ritalin, and none on Concerta. My insurance dropped brand name (which has had no shortages! Go figure!) and the generic I can get my hands on is genuinely awful. If it turns out they're actually sugar pills, I'd believe it.

Independent pharmacies are getting straight-up gouged by the pharma companies. Anything in demand is being sold well above the regular price, and the little guys can't afford to take insurance if, for example, a 100 count bottle costs $180-200 and insurance will only pay $20 per 30 pills. Right now it's in the best interest of the generic manufacturers to pump this out and quadruple the price of a bottle, because who's going to stop them? It's nuts. I'm certain someone powerful has their hand in the pie.

 

[Sicko Hunter]

Prescribed Adderall. I've been unable to get twice bc shortage, I also have to manually ask on the fucking app for a refill everytime. I don't even take it every day. Just days when I work or if I have a brutally long backpacking trip.

How do you order from India? Can Americans do that?

During the height of the shortage I would literally have to call half a dozen pharmacies or more to even find one that had it. Such a nightmare. I haven't had issues filling it for the past 3-4 months. A smart move is to get on a dose larger then you take then squirrel away extra pills for a rainy day.

 

[Agent Abe Caprine]

Most people on Concerta are on the generics that don't have what makes Concerta Concerta. Only generic that did have that got discontinued. Generic Concerta should just be called generic Ritalin XR. Forgot what it was that was unique to Concerta and that discontinued generic, but it had something to do with how it did the whole extended release thing.

Don't notice a difference between name brand Concerta and the generic Ritalin XR, but it could be due to my caffeine consumption.

 

[kobrum]

It also isn't essential. There are plenty of synthetic derivatives that work as well or better. No one needs "Desiccated Thyroid", some people find for them that it is easier to balance their thyroid function, but it can be done with synthetics without risk to efficacy. The majority of people who take it do so out of preference more than anything.

kinda surprised you can say this part when you use your own example for something being the only thing working for you. Like you say at the end of your post, some meds straight dont work as well for some people and some work much better for some. a lot of meds are absolutely "essential", even if there are alternatives available.

Slight aside, on most prescriptions, there is a code that doctors can use to pretty much say "only give my patient this med" and its used with good reason. When a person (not the doctor) wants a specific med, there is a code for that too, and pharmacies can swap that one out as needed.

 

[Sniperwoof]

Gonna PL hard but I've lost almost 100lbs on bootleg compounded ozempic and I doubled down and got some bootleg testosterone as well to help build muscle/help with loose skin.

I went from a big ole fatty to someone genuinely healthy and happy.

I would step over the corpses of a thousand diabetic children to get my weekly shot.

My shot costs me $250 a month for weekly injections compounded with B12. The same shot name brand would cost me $1200 a month.

These shortages are financial and bureaucratic not due to complications making the drug, if shit hit the fan these compounding pharmacy's would switch to antibiotics just like they switched to ozempic.

In short, look at compounding pharmacy's not many people known they exist but they are a life saver.

Your body is going to be 90% tumors in 20 years. Stop being a lazy fuck and diet/exercise instead.

 

[Tiggletown]

Your body is going to be 90% tumors in 20 years. Stop being a lazy fuck and diet/exercise instead.

Die, nigger.

 

[Mob Boss Barbie]

Most people on Concerta are on the generics that don't have what makes Concerta Concerta. Only generic that did have that got discontinued. Generic Concerta should just be called generic Ritalin XR. Forgot what it was that was unique to Concerta and that discontinued generic, but it had something to do with how it did the whole extended release thing.

Don't notice a difference between name brand Concerta and the generic Ritalin XR, but it could be due to my caffeine consumption.

Generic Concerta should be renamed "poorly developed XR (an IR) that will make you grind your teeth like a meth head."

The difference is the OROS triple-layer release system in the Janssen patent, and their Patriot subsidiary was manufacturing the authorized generic until January 2022 when it was discontinued. The block on generics expired and all the shitty ones were allowed to flood the market. It's my understanding this happens in a cycle. Subpar generics get authorized -> FDA eventually does a review, says they're not even close to spec, and pulls them -> only Janssen remains -> generics get re-authorized -> repeat.

 

[Maori Kiwifruit Growers]

Generic Concerta should be renamed "poorly developed XR (an IR) that will make you grind your teeth like a meth head."

The difference is the OROS triple-layer release system in the Janssen patent, and their Patriot subsidiary was manufacturing the authorized generic until January 2022 when it was discontinued. The block on generics expired and all the shitty ones were allowed to flood the market. It's my understanding this happens in a cycle. Subpar generics get authorized -> FDA eventually does a review, says they're not even close to spec, and pulls them -> only Janssen remains -> generics get re-authorized -> repeat.

I stand corrected about the Israelis