Drug Shortage: Causes, Impact, and Mitigation Strategies

Abstract

Drug shortage is a global issue affecting low, middle, and high-income countries. Many countries have developed various strategies to overcome the problem, while the problem is accelerating, affecting the whole world. All types of drugs, such as essential life-saving drugs, oncology medicines, antimicrobial drugs, analgesics, opioids, cardiovascular drugs, radiopharmaceutical, and parenteral products, are liable to the shortage. Among all pharmaceutical dosage forms, sterile injectable products have a higher risk of shortage than other forms. The causes of shortage are multifactorial, including supply issues, demand issues, and regulatory issues. Supply issues consist of manufacturing problems, unavailability of raw materials, logistic problems, and business problems. In contrast, demand issues include just-in-time inventory, higher demand for a product, seasonal demand, and unpredictable demand. For regulatory issues, one important factor is the lack of a unified definition of drug shortage. Drug shortage affects all stakeholders from economic, clinical, and humanistic aspects. WHO established global mitigation strategies from four levels to overcome drug shortages globally. It includes a workaround to tackle the current shortage, operational improvements to reduce the shortage risk and achieve early warning, changes in governmental policies, and education and training of all health professionals about managing shortages.

International trends in prescription opioid sales among developed and developing economies, and the impact of the COVID‐19 pandemic: A cross‐sectional analysis of 66 countries

“…First, there is clear evidence of widespread interruptions in global supply chains for pharmaceuticals, which led to threats of shortages in many countries, particularly early in the pandemic. 14 , 19 , 20 As a result, many countries introduced limits on the duration of chronic medications, including opioids, which could be dispensed to protect unstable drug supplies and prevent gaps in access for patients. 19 , 21 Second, as public health restrictions were introduced around the world, many people experienced challenges accessing healthcare providers, and there was a reduction in surgeries and dental services which as often associated with opioid use.…”

“…This is likely explained by two pandemic‐related factors. First, there is clear evidence of widespread interruptions in global supply chains for pharmaceuticals, which led to threats of shortages in many countries, particularly early in the pandemic 14,19,20 . As a result, many countries introduced limits on the duration of chronic medications, including opioids, which could be dispensed to protect unstable drug supplies and prevent gaps in access for patients 19,21 .…”

Educating the managers of the bioeconomy

“…19 Besides cutting the cost of shipping, this will end the reliance on foreign suppliers for substances that can be of vital importance for entire countries, as shown by the prolonged shortage of active pharmaceutical ingredients (APIs) not only in low-income countries but also in industrially developed countries such as the USA, European and Oceania countries. 20…”

Drug shortages in low- and middle-income countries: Colombia as a case study

“…The United States has experienced hundreds of drug shortages in the past decade [ 1 ]. While high-, middle- and low-income countries all deal with shortages [ 2 ], documentation of shortages has focused on high-income countries (HICs) [ 3 ]. There are hundreds of papers about US shortages [ 4 ].…”