Drug shortages in U.S. reach a record high

The diabetes drug Ozempic is facing a surge in demand. PHOTO: F. MARTIN RAMIN/THE WALL STREET JOURNAL
The diabetes drug Ozempic is facing a surge in demand. PHOTO: F. MARTIN RAMIN/THE WALL STREET JOURNAL

Summary

Certain antibiotics, allergy treatments, chemotherapy drugs and popular drugs used for weight loss such as Ozempic are among hundreds of medicines now in short supply.

Drug shortages in the United States have reached an all-time high.

Supplies are low for everything from lifesaving injections to diabetes medications, according to data from the University of Utah Drug Information Service, which tracks shortages. Among the medicines affected are popular diabetes drug Ozempic, lifesaving allergy treatment epinephrine, child-friendly forms of the common antibiotic amoxicillin, chemotherapy medications and injections hospitals commonly use in intensive care.

A total of 323 drugs were in shortage in the first quarter of 2024, up from the previous high of 320 in 2014, according to the Utah data published by the American Society of Health-System Pharmacists. That’s the highest since the Utah group began tracking in 2001.

Many of the drugs are generics. The shortages mean some patients must visit multiple pharmacies to find a drug or wait longer to receive a key treatment or get second-choice substitutes or pay more if a generic drug is unavailable but the brand is. Shortages can also put patients at higher risk of medication errors as hospitals scramble to adjust doses.

“It was like a panic" when Stan Brady’s pharmacy ran out of Eli Lilly’s diabetes drug Mounjaro recently and he couldn’t refill the prescription he has been taking for more than two years to control his blood-sugar levels, said Brady, 68, of Bratenahl, Ohio.

Brady needs to take a diabetes drug to avoid the complications that can result if blood-sugar levels get out of control. His doctor switched him to another diabetes drug, but Brady said so far it hasn’t controlled his blood sugar as well as Mounjaro did.

“I just find it amazing that you can’t find this stuff, and nobody seems to be doing anything about it," Brady said.

Lilly said “an unparalleled surge in demand" for Mounjaro and a cousin drug, the anti-obesity treatment Zepbound, have limited their availability. The company also has seen supply disruptions for an older diabetes drug, Trulicity.

“We recognize this situation may cause a disruption in peoples’ treatment regimens and are working with purpose and urgency to address it," the company said.

Lilly is investing in manufacturing and supply capacity to increase production of Mounjaro and Zepbound throughout the second half of 2024. The company said it expects intermittent availability in the near term due to the unprecedented demand.

Supplies of many medicines have been a continuing and worsening problem in recent years.  While some brand-name drugs such as Ozempic are running short simply because their makers haven’t yet caught up with demand, health economists have pinned most shortages on a broken pharmaceutical supply chain that makes it difficult for generic drugmakers to make a profit and stay in business.

Many generic-drug makers have left the business or offshored to countries where labor is cheaper, such as India. Shortages can result, and linger, if a factory pauses production. There are few suppliers to pick up the slack, and it isn’t easy to jump-start manufacturing of a particular drug, especially the sterile injectables that are so tricky to make and that hospitals use so often.

“We’re not seeing very many shortages resolved," said pharmacist Erin Fox, who leads the shortage data collection for the University of Utah. “For many of these drugs, there really are one or two suppliers so as you lose capacity there, there isn’t additional redundancy."

Joel Zivot, an anesthesiologist and intensive-care doctor at Emory University Hospital, said he is constantly having to substitute one drug for another due to shortages. “These substitutions are extraordinarily frustrating," he said. “This happens every day."

Continuing shortages reached a similar peak in 2014, then abated for several years. They’ve been on a mostly steady upswing since 2021. New shortages include Rifaximin tablets, which are used to treat diarrhea, and meperidine hydrochloride injection, used to treat pain during surgeries.

Fixing the problem will probably involve changing the business model, including taking steps that would increase the prices of generic medicines so sales can support manufacturers and attract additional companies, according to researchers and policymakers.

The White House earlier this month proposed spending between $3.26 billion and $5.11 billion over a decade to help address shortages. The plan would include linking Medicare payments to hospitals in part on whether hospitals do a good job buying drugs from companies that demonstrate quality over the long term, rather than just the cheapest price. The proposal would need approval and money from Congress.

Policymakers have also proposed giving the Food and Drug Administration more power to demand information about shortages and pending shortages, since the agency has little information now. Currently the FDA is mostly limited to calling manufacturers and asking if they can step up supply to make up for shortfalls elsewhere.

“Right now we have spotty pieces of information about what’s going on out there from the manufacturers," FDA Commissioner Dr. Robert Califf told the House Oversight Committee Thursday. “We spend a lot of time on the phone."

The Federal Trade Commission recently launched an inquiry into whether companies that buy drugs in bulk for hospitals, known as group purchasing organizations, cause or exacerbate shortages.

Jennifer Calfas contributed to this article.

Write to Liz Essley Whyte at liz.whyte@wsj.com and Peter Loftus at Peter.Loftus@wsj.com

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