Drug Shortages

Drug Shortages & Pricing:

The United States is facing an increasing number of drug shortages, which a recent Senate report frames as a national security threat. The drugs in short supply range from medications for attention-deficit/hyperactivity disorder (ADHD), antibiotics, and IV saline, to children’s flu medications. The consequences for patients and health care providers are devastating. In addition, drug affordability continues to be a concern, with nearly 1,000 drugs experiencing price increases so far this year.

• Adderall Shortage: The Food and Drug Administration reports that previous manufacturing delays have been resolved and the Adderall shortage is now driven by demand. A new Centers for Disease Control and Prevention report points to increased prescriptions for ADHD during the COVID-19 pandemic and expanded telehealth access to these prescriptions.
• The Impact of Shortages: The Adderall shortage has forced patients to ration their medication, including those who need it for narcolepsy. The drug shortage also impacts hospital and cancer care. A doctor reports the difficulty in weighing which patient should receive the limited number of doses of a cancer drug called etoposide.
• Addressing the Cost of Insulin: Many people with diabetes cannot afford their insulin, which is capped at $35 for those under Medicare. Civica partnered with Blue Cross Blue Shield companies to bring down the cost of insulin by making generic options available. California also partnered with Civica to create an affordable insulin option through the CalRx initiative. Drugmakers recently announced cutting the price of insulin drugs.

Initiatives & Resources:

• U.S. Pharmacopeia created a Medicine Supply Map, an early-warning system for possible drug shortages, to increase supply chain preparedness.
• A group of Blue Cross Blue Shield-affiliated companies founded a new medication contracting organization called Synergie Medication Collective, which focuses on addressing affordability and access of medical benefit drugs.
• Learn how you can avoid sticker shock on prescriptions.
• Under NIHCM grants, the Tradeoffs podcast released an episode on America’s Chronic Drug Shortage Problem and Healthcare Triage shared information on drug development and approval.

Mental Health & Substance Use Disorders

The US continues to grapple with increasing rates of mental health and substance use disorders, as well as limited resources and barriers to care. The current rise in drug overdose deaths is attributed to fentanyl, which the Department of Homeland Security Secretary has called the “single greatest challenge” facing the country. To combat the overdose crisis, the FDA has approved Narcan, a nasal spray version of naloxone, to be sold over the counter.

• Screening and Telehealth: A new NIH study identifies genes associated with underlying substance use disorders, which could help create more effective prevention and treatment strategies. A CDC press release highlights the findings of a recent study that found the increase in telehealth services for opioid use disorder reduced the risk of fatal drug overdoses.
• Children’s Mental Health: A recent study cites the increasing number of children with suicidal or self-harming behavior. One study found a connection between excessive screen time and mental health problems in youth. Another study found a connection between parenting style and increased risk of mental health symptoms.

Resources & Initiatives:

• See NIHCM’s resources on behavioral health and substance use.
• Wellmark Blue Cross and Blue Shield and the 437 Project are working to create more resources and awareness surrounding suicide.
• The BlueCross BlueShield of South Carolina Foundation is addressing infant mental health, a critical time for children’s brain development.
• Horizon Blue Cross Blue Shield of New Jersey is funding a program to teach people to recognize the warning signs of suicide in youth.
• Under a NIHCM grant, STAT released articles on how to protect people with addiction from discrimination and how methadone clinics can offer more take-home doses.

In Other Public Health News…

Medicaid Unwinding

Pandemic protections ended April 1 and states have started cutting off Medicaid coverage. As many as 15 million people could lose coverage. This includes seven million people who are still eligible and who will have to re-enroll. Nearly half of the 15 million individuals predicted to lose coverage are Black or Latino.

• A new Tradeoffs podcast episode digs into three research articles to explain “The Treacherous Transition Awaiting Millions Losing Their Medicaid.”

Resistant Infections

Antibiotic resistance is a growing concern, with the WHO reporting that there are insufficient new drugs to address increasingly resistant infections. Scientists are concerned with how multiple strains of the stomach bacteria Shigella have acquired resistance to the five antibiotics most commonly used to treat it. Additionally, this CDC press release addresses the threat of antimicrobial-resistant fungus spreading in health care facilities.

• Learn more about antimicrobial resistance from this CDC resource.

Women’s Health

Women are underrepresented in health care research. Topics relevant to women’s health, such as menopause, are often taboo. Elevance Health is promoting the inclusion of women in clinical trials and an op-ed from Premera Blue Cross shares the challenges of navigating health care as a woman.

• NIHCM’s webinar yesterday explored women’s health access, focusing on the impact of Medicaid and family planning. Slides are available and the recording will be available next week.