by George Miller and Skye Toor
Doctors, pharmacists and even the U.S. Congress use terms like "unprecedented," "crisis" and "significant risk" to describe current U.S. drug shortages. "We're getting to a tipping point, where we won't have medicines on the shelves," says Erin Fox, manager of the University of Utah Hospitals' Drug Information Service (DIS), a tracker of drug shortages, in an interview.
DIS began tracking pharmacist-reported drug shortages as a service to members in 2000, and began a partnership with another shortage tracker, the American Society of Health-System Pharmacists (ASHP), in 2001.
Drugmakers, for their part, are fairly tight-lipped about shortages. Some voluntarily offer information to the FDA, which makes it publicly available. But they provide the scantest of details. Congress is proposing rules to make drugmakers be more forthcoming with shortages data.
"For close to half of shortages, drugmakers won't tell us the reason," says Cynthia Reilly, director for ASHP's practice development division, in an interview. The reason is important in helping her members manage the shortfall. "If it's a shortage of raw ingredients," she says, "that's a longer-term problem than particles in vials."
The most common reasons for drug shortages are increased demand, shortages of active ingredients, and manufacturing delays, whether brought on by corporate production upgrades or FDA-mandated remediation.
Here's our list of the top shortages as of early August. We define "top" as those shortages listed among condition or treatment category that have the greatest number of drugs in short supply.
Top Drug Shortages by Condition/Treatment