Adderall, Chemotherapy Drugs and More in Short Supply Across the U.S.

Drug shortages aren’t new — but they are getting worse.

The American Society of Health-System Pharmacists (ASHP) has been closely tracking U.S. drug shortages for the last 20 years, and unfortunately, according to its data, the first three months of 2024 has seen a record high of active and ongoing drug shortages. Some 323 drugs are in short supply, the highest number since the organization began compiling this data in 2001.

Affected drug classes include "basic and life-saving products," according to the latest ASHP report, such as chemotherapy, painkillers, sedatives and medications used to help with the delivery of babies. "Emergency medications stored in hospital crash carts and procedural areas" are also implicated, according to a separate ASHP statement calling for policy solutions to what it calls a "crisis."

ADHD medications have also been in short supply for years now, with the FDA having announced a shortage of Adderall in October 2022.

And along with ongoing supply chain issues and the Drug Enforcement Agency (DEA) quota changes on controlled substances, one of the likely culprits behind the shortages is, paradoxically, one that also increases patient access to medications: the production of generics.

How generic medications spur drug shortages

Many of the shortages listed in the ASHP report are generics, the organization says — including injectables like standard-of-care chemotherapy medications. While generics, because they’re more affordable, can lower the cost of health care for the patient, they also net little financial return for manufacturers — leading some to halt their production altogether.

In other cases, manufacturers may wind up cutting corners to make the production of generics more financially viable, sacrificing quality in the bargain.

The problem is not a new one — studies have suggested this trend’s impact on generic drugs, specifically, for over a decade. But it is one that, given the record high of medications in short supply as per the first quarter of 2024, is in need of a sustainable solution.

To that end, the Department of Health and Human Services (HHS) recently released a white paper aimed at preventing drug shortages, offering suggested policy reforms that would "bring transparency into the market, link purchasing and payment decisions to supply chain resilience practices, and incentivize investments in supply chain resilience and diversification in the supply chain." These include urging collaboration between the HHS and the private sector to implement resiliency programs on both the manufacturing and consumption sides of the equation.

The Biden administration, too, has publicized action steps to help strengthen the supply chain while keeping costs low, including utilizing the Defense Production Act to broaden the HHS’s ability to invest in the production of essential medicines — with some $35 million worth of such investments already earmarked.

Still, such programs and policies have yet to be enacted — and their eventual effects on drug supply will likely take time to trickle down to providers and their patients.

Finding medicine is one thing — but affording it is another

The availability of required medicines is only one (important) part of a larger problem — ValuePenguin, too, has found that medication or medical equipment shortages impact nearly one in five Americans.

But even when they’re in ample supply, many Americans struggle to afford the medications they need. Especially without prescription insurance (or Medicare Part D, for those who qualify), the costs of even common drugs can quickly stack up. For instance, birth control pills can cost $50 per month out of pocket, or an annual total of $600.

Of course, affordability is even more challenging with patented drugs that have yet to achieve a generic equivalent. Semaglutide drugs used to induce weight loss and treat diabetes, like Ozempic and Wegovy, are prime examples: The injectables cost an average of more than $1,100 monthly.

Fortunately, this problem, too, is not a new or unknown one, and policymakers are working to help lower the cost of medication for Americans. For example, thanks to the Inflation Reduction Act of 2022, Medicare is now allowed to negotiate the price of brand-name drugs, which it is currently in the process of doing. Drug-cost-reducing actions can be taken at the state level, too, as New York has begun with its recent package of seven such bills.

Still, in the short term, drugs may remain for many patients both hard to find and hard to pay for, even with health insurance (which may require coinsurance or a copay). Online pharmacy platforms like GoodRX can help in some instances, but keep in mind that your health insurance may not pay for drugs purchased through these programs.