Medication and Medical Equipment Shortages

The COVID-19 disruption of supply lines has had long-lasting impacts on the availability of medications and medical equipment across the United States. However, the shortages associated with the pandemic are not a new phenomenon. They have become a more prominent concern in recent years, increasing both in frequency and breadth. However, medication shortages are a decades-old concern in the United States health care system. So what causes these shortages, who is the most affected by them, and what can we expect going forward?

Causes

There are several, often overlapping, reasons that a drug or medical supply may be subject to shortages. Some of the most common include:

Limited Manufacturing Sources

• The medical manufacturing industry is extremely specialized, and most medication and medical supplies have a small number of producers. This means there are larger consequences when anything goes wrong in the supply line or production of a product at one manufacturer. The situation is similar if one manufacturer puts out a recall. This is because there is very little that other manufacturers can do to offset the problem.

Complicated/Unstable Supply Lines

• The manufacturing and shipment of medical products can have a number of steps. This can include steps both domestically and abroad, depending on what is being produced. In times when disasters, changes in trade policy, or other factors interrupt any of these steps, it can be difficult to work around the missing materials. This leads to an inability to meet consumer demand.

Disasters

• As emphasized by the broad-reaching effects of COVID-19, unexpected disasters can create unpredictable conditions. This can result in manufacturing, distribution, and demand all being thrown out of their normal balance. Conditions such as lockdowns, storms, and so on create shortages in labor, destruction of plants and equipment, and shipment difficulties. Disasters also create higher demand for medications and other supplies that manufacturers have no way of predicting. As a consequence, the demand cannot be adequately met at the time that it spikes.

Poor Communication

• Manufacturers are not always required to report anticipated shortages, supply chain issues, or other difficulties affecting their production and distribution that may appear. This lack of transparency means that health care providers seldom have means to prepare for upcoming shortages. This happens either in supply management or seeking alternate products. Providers then typically have to wait until the manufacturer(s) of the affected product are able to return their production and distribution to expected levels. Failure to communicate appropriately with regulatory bodies or purchasers can also contribute to the issue of stockpiling. This is where purchasers buy large quantities of a product in anticipation of it being hard to procure in the near future. This further exacerbates shortages already in development and creates shortages where no previous cause for concern was present.

Affected Populations

Anyone who needs medical intervention can be affected by a medical product shortage. However,  some are hit harder than others when manufacturers are unable to keep up with demand. Those who rely on intravenous drugs, for example, are at a higher risk of negative outcomes when they have to use alternative medications. This is due to the complicated production process, which makes manufacturing errors more common. In addition, there is a relatively small number of intravenous drug manufacturers approved in the United States. This means that alternative medications might come from an unregulated source. This increases the risk of low-quality product that will have adverse effects on the person taking them.

Low-income and rural populations are also more likely to be heavily impacted by medical supply shortages. The high cost of products during shortages can be a significant barrier for people that need them. This is assuming that the products in question are available where they live. Additionally, in small or isolated communities, the distance to the nearest hospital or distribution center can be a barrier. This often means that providers in these areas are hard-pressed to bring their patients the interventions they need.

Future Measures

Those involved in the medical field are currently pushing for change to the way that manufacturing, distribution, regulation, and communication work in the United States’ health care system. The FDA’s most recent report to Congress emphasized a need for better insight into the current supply chain. This will hopefully inform the ways that the FDA can assist in creating resiliency in the supply chain and limit the effects of mishaps when they occur. Other bodies have suggested that the FDA require transparency (as opposed to the current voluntary reporting system) from manufacturers when they come across problems that will cause shortages.

Additional Learning

For a full, updated list of national drug shortages, visit the FDA’s page at https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm

STM Learning, Inc. is committed to bringing readers up-to-date and accurate information on topics regarding health, maltreatment, abuse, and human rights concerns. As the health care field adapts and faces new challenges in the wake of COVID-19, our upcoming materials will continue to reflect changes made to the policy and practice of patient care. Keep an eye out for our upcoming books, Mental Health Issues of Child Maltreatment: Contemporary Strategies and Gender-Based Violence Across the Continuum: Trauma-Informed Care, for more information on how providers are continuing to serve their communities in a post-pandemic world.

This blog was written by STM Learning’s editorial staff for educational purposes only. It is not intended to give specific medical or legal advice. For expert information on the discussed subjects, please refer to STM Learning’s publications.