Odds are, by now, you’re tired of hearing about the global supply chain. Shortages have become part of the new normal, from computer chips to ground beef and everything in between. And they’re expected to last until well into this year, if not beyond.
When it comes to the goods on that list, the prospect of facing empty shelves creates more of an inconvenience than anything else. We’ve all had to switch brands or find substitutes for mainstay items over the past year. But one area where these supply chain hiccups can create more significant problems is in the world of pharmaceuticals.
EXPOSING VULNERABILITIES
While drug shortages are nothing new—the FDA currently lists over 160 drugs on backorder, including heart medications, antibiotics, and cancer drugs—the pandemic has created other snags and disruptions that impact supplies.
According to a new U.S. Pharmacopeia (USP) survey, seven of 10 U.S. physicians say that the COVID-19 pandemic has heightened drug supply chain problems, limiting their ability to provide quality patient care. Even more disheartening results from the same study show that nearly all doctors (95%) said the COVID-19 pandemic revealed vulnerabilities in the drug supply chain. Furthermore, 90% also said that the global supply chain might not be reliable in a crisis.
SOURCING ISSUES
The U.S. manufacturing base to make many essential medicine ingredients has dwindled over the last few decades, leaving little domestic capacity. As a result, an estimated 80% of the world’s active pharmaceutical ingredients (APIs) come from China, India, and a handful of other foreign countries. For many materials, there is a single, foreign source. This over-reliance on China and India for APIs and the key starting materials (KSMs) required to produce them is troubling—a fact that was driven home when India imposed an export ban on medicines at the height of the pandemic.
When input is limited to so few sources, shortages can occur for many reasons—from compliance with proper manufacturing practices to regulatory delays and more. In addition, limited raw materials can further hamper production, as can energy shortages, high COVID infection rates among employees, and transportation snarls.
It all contributes to creating an uncomfortably fragile supply chain for critical materials.
THE GOOD NEWS: MANY WIDELY USED DRUGS REMAIN LARGELY UNAFFECTED
According to Andrew Mulcahy, Ph.D., a senior policy researcher at The RAND Corporation, most pharmaceutical shortages have more directly affected sterile injectable drugs and older, less profitable drugs.
“They tend to be drugs that are manufactured in and around the U.S.,” he says. “Companies maybe over time didn’t find it as profitable to make these older injectable drugs, so they got out of the business and now there’s just one manufacturer left. Some disruption happens there, and the supply really dries up.”
Yet supplies of many of the most extensively used pills have remained reasonably stable throughout the pandemic, Mulcahy says. “For a lot of the more traditional prescription drugs, they’re manufactured in very big batches, and companies buy an awful lot at one time. So, they typically have months of stocks to work with before they run out,” he continues.
In addition to these stockpiles, there are workarounds for essential drugs so that patients can get the treatment they need in many cases.
WHAT’S BEING DONE
Given their survey findings, USP has recently announced a partnership with health care groups like the American Medical Association, the American Society of Anesthesiologists, the American Society of Health-System Pharmacists, and the Association for Clinical Oncology to address the challenges faced by the drug supply chain.
The groups have released a series of policy and marketplace recommendations asking policymakers to undertake several legislative and regulatory actions. These include incentivizing the development of advanced manufacturing technology for critical drugs, improving the function and accessibility of the U.S. Strategic National Stockpile (SPS), and improving international cooperation with foreign supply chain partners.
WHAT YOU CAN DO
The issue that impacts everyone is the simple question of what people should do if they have trouble finding their medicine.
In this case, pharmacists and doctors agree—don’t panic or panic buy.
Even though many local pharmacists must deal with longer waits for over-the-counter drugs, they encourage patients to talk to them to see what can be worked out. You may also want to call other pharmacies and check their supply or speak to your doctor to find out if alternative medications might be easier to find.
At Health & Benefits partners, helping you safeguard your health is our primary concern. As your comprehensive broker for individual, group, and Medicare insurance, we’re committed to leveraging our expertise to help you in any way we can. If you have questions about how issues like the pharmaceutical supply chain may impact your health coverage, reach out today.