Drug shortages in the U.S. have become a pressing issue, impacting patient care, health care costs, and the overall health care system. According to the U.S. Pharmacopeia, the number of drug shortages has increased dramatically over the past decade, from 82 FDA-monitored drug shortages in December 2014 to 125 shortages in December 2023.1 A primary concern is the increasing frequency and duration of shortages.
A recent report from IQVIA (a provider of technology, analytics, and research services to the life sciences industry) noted that therapeutic areas impacted by drug shortages include pain/anesthesia, oncology, central nervous system, and infectious disease, as well as the recent shortages seen with GLP-1 medications used to treat diabetes and weight loss.2 Of the 132 medications in shortage as of June 2023, 75% have been active shortages for more than one year and 58% have been ongoing for greater than two years.2
Impact on patient safety & clinical outcomes
When a patient does not have easy access to their medication, health care providers will often look to alternative drug therapies to treat their condition. This could lead to adverse drug reactions, interruptions in treatment, drug errors, as well as increases in hospitalization or utilization of other health care services. Antimicrobials and oncology medications are the medication classes most tied to poor patient outcomes. 3 For example, medication errors may occur due to clinicians being unfamiliar with the alternative therapies. One study found that in 54% of drug shortages, clinicians may be unfamiliar with the alternative product regarding its mechanism of action, adverse effects, or interactions.4 Additionally, patients requiring chemotherapy or critical antibiotics may face interruptions in their treatment regimens, increasing the risk of disease progression or complications.
Impact on drug costs
From a cost perspective, plan sponsors may face significant financial implications. When shortages occur, health care providers may resort to using higher-cost alternatives or off-label medications, leading to increased claims and higher premiums for self-funded medical and pharmacy benefits. Additionally, employees may experience higher out-of-pocket costs if they are required to pay for more expensive alternatives or if their treatment plans are disrupted. One analysis observed between a 7.2% and 16.6% increase in drug prices for insured patients 12 months after a shortage occurs.5 The financial impact of drug shortages can also extend beyond immediate costs. Delayed treatments may result in more severe health issues, leading to increased hospitalizations and long-term care needs, which can further inflate health care costs for plan sponsors.
Plan sponsors should assess the following key considerations:
- Stay informed about regulatory changes and ensure that your health plan and pharmacy providers comply with any new requirements related to drug availability.
- Collaborate with your pharmacy provider and Marsh McLennan Agency (MMA) to develop protocols for addressing shortages, including communication strategies with both health care providers and patients.
- Connect with your pharmacy provider and MMA to understand the potential financial and clinical impact of moving patients to alternative therapies.
How can Marsh McLennan Agency Help?
Marsh McLennan Agency’s team is here to help you evaluate and manage your pharmacy program. We are a trusted partner who can identify real opportunities for savings and help you make sense of your program, control your spend, and deliver savings to your organization. Learn more about how our Pharmacy Practice can provide end-to-end plan support to fit your organization’s needs.
This article was originally featured in our Rx Newsletter. Sign up to receive our quarterly newsletter emails.
Sources:
- “The U.S. drug shortage crisis, in 5 charts,” Advisory Board Daily Briefing, accessed October 21, 2024, https://www.advisory.com/daily-briefing/2024/06/13/drug-shortages.
- Aitken M, et al., “Drug Shortages in the U.S. 2023.” IQVIA Institute for Human Data Science, accessed October 29, 2024, https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/drug-shortages-in-the-us-2023/drug-shortages-in-the-us-2023.pdf.
- Minh Phuong J et al., “The impacts of medication shortages on patient outcomes: a scoping review,” PLoS One, accessed October 21, 2024, https://pmc.ncbi.nlm.nih.gov/articles/PMC6499468/.
- Fox ER, Tyler LS., “Managing drug shortages: seven years’ experience at one health system,” Am J Health Syst Pharm, accessed October 21, 2024, https://doi.org/10.1093/ajhp/60.3.245.
- “Impact of Drug Shortages on Consumer Costs. U.S. Department of Health and Human Services,” Office of the Assistant Secretary for Planning and Evaluation report to Congress, accessed October 21, 2024, https://aspe.hhs.gov/sites/default/files/documents/87781bc7f9a7fc3e6633199dc4507d3e/aspe-rtc-costs-drug-shortages.pdf#:~:text=Consumers%20may%20incur%20increased%20costs%20in%20the%20form,incur%20costs%20to%20manage%20or%20mitigate%20drug%20shortages.
