Healthy Returns: U.S. drug shortages reach record high, hitting Wegovy, ADHD medications

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Good afternoon! Drug shortages in the U.S. are at a record high, leaving countless patients in limbo. 

A total of 323 drugs were in shortage in the first quarter of this year, up from the previous high of 320 in 2014, according to data published last week by the American Society of Health-System Pharmacists and the University of Utah Drug Information Service. That's the most medicines since the groups began tracking shortages in 2001.

So, which drugs do the shortfalls affect?

Supplies are low for everything from lower doses of Novo Nordisk's blockbuster weight loss drug Wegovy, certain doses of Eli Lilly's popular diabetes injection and weight loss counterpart Zepbound, to key cancer treatments and common antibiotics. Many of them are generic medications, which make up a majority of Americans' prescriptions.

"All drug classes are vulnerable to shortages," Paul Abramowitz, CEO of the American Society of Health-System Pharmacists, or ASHP, wrote in a blog post on Thursday.

But he said "some of the most worrying shortages involve generic sterile injectable medications, including cancer chemotherapy drugs and emergency medications stored in hospital crash carts and procedural areas." Ongoing scarcity of ADHD medications "also remain a serious challenge for clinicians and patients," Abramowitz added. 

The drug shortage database maintained by the two organizations is based on voluntary reports from practitioners, patients and others. The figures are confirmed with drugmakers. This list often includes more drugs than the number the Food and Drug Administration considers to be in shortage. 

It's unclear how many patients are impacted by the current drug shortages. But the average shortage from 2016 to 2020 affected at least half a million patients, many of whom are older adults, according to an analysis the Department of Health and Human Services shared with Congress in May. 

The shortages can create serious problems.

Margot Wood, an Oregon-based author of the book Fresh, said intermittent shortages of ADHD medications have disrupted her daily life for roughly a year and a half. Wood said she can generally function without the drugs, but noted that every task is "much more complicated and difficult" and "takes three times as long" to do. 

"I need them not just for work, but also for my relationships, being a mom, in my hobbies and things and just keeping up with my day-to-day life," Wood told CNBC. 

While patients in some states can scour different pharmacies for the medication they need, Wood said there isn't much she can do in Oregon. That's because Oregon considers ADHD medications controlled substances, meaning Wood can only fill her prescription at her designated pharmacy. 

When her medication does go back in stock, Wood said she often rations her supply to prepare for potential shortages in the future. She added it is "frustrating" that the reason behind the shortages isn't clear to patients and even some pharmacists. 

So, what exactly is driving drug shortages? And how can the issue be fixed? 

Around 60% of drug manufacturers did not disclose the factors behind the scarcity of medications, according to the new data from ASHP and the University of Utah Drug Information Service. 

Some drugmakers said demand has outstripped supply, which has been the case with buzzy weight loss and diabetes medications. Others said manufacturing and quality problems, such as supply chain gaps, played a role. 

But the Biden administration has suggested a deeper issue may cause shortages, particularly of generic drugs.

In February, the Federal Trade Commission and HHS said they are examining the role that drug wholesalers and companies that purchase medicines for U.S. health-care providers play in those shortages. The agencies will determine whether those middlemen have misused their market power to cut the prices of generic drugs to the point that manufacturers can't profit and have to stop production, and rival suppliers are discouraged from competing in the generic drug market. 

The Biden administration has taken other steps to tackle drug shortages. Last week, HHS outlined policy recommendations to help prevent supply deficiencies and mitigate vulnerabilities. 

That includes collaborations with drugmakers and hospitals that aim to make the drug market more transparent and encourage companies to invest in resilient and diverse drug supply chains.

Abramowitz on Thursday said some of the recommendations align with those of ASHP, but the organization has "serious concerns" about certain parts of the plan. He pointed to a proposal that could penalize hospitals that lack the resources to comply with the recommendations. 

"Much work remains to be done at the federal level to fix the root causes of drug shortages," Abramowitz wrote.

Feel free to send any tips, suggestions, story ideas and data to Annika at annikakim.constantino@nbcuni.com.

Latest in health-care technology

UnitedHealth reveals financial impact of Change Healthcare cyberattack

All eyes were on UnitedHealth Group on Tuesday morning as the company reported first-quarter results that gave investors a window into the cost of the Change Healthcare cyberattack. 

UnitedHealth said its earnings took a 74 cents per share hit from the breach in the first quarter, and it expects the full-year impact to be between $1.15 and $1.35 per share.

"The core story at UnitedHealth Group remains our colleagues delivering improved experiences for the people we serve and driving balanced growth even while swiftly and effectively addressing the attack on Change Healthcare," UnitedHealth CEO Andrew Witty said in a release.

UnitedHealth, which owns Change Healthcare, discovered that a cyber threat actor had breached part of the unit's information technology systems in February. The company had to shut off the affected systems, temporarily leaving many doctors without a way to fill prescriptions or get paid for their services. Many are still contending with the fallout. 

Shares of UnitedHealth were up more than 5% as of 11 a.m. ET on Tuesday.

UnitedHealth's Optum acquired Change Healthcare for $13 billion in 2022. The merger was controversial, as groups like the American Medical Association claimed the union could stifle competition. The Justice Department sued to block the acquisition that year, but the deal eventually went through.

In the company's quarterly call with investors Tuesday, Witty said UnitedHealth's ownership of Change Healthcare is "important for the country." He said the attack likely would have happened either way, but if UnitedHealth did not own the company, Change Healthcare would not have had the resources or support necessary to bring its systems back online. 

"We're going to bring it back much stronger than it was before," Witty said.

UnitedHealth CFO John Rex said during the call that the company's insurance unit, UnitedHealthcare, is "pretty much back to normal in terms of claim submission activity" in the wake of the cyberattack. He said claims are flowing as expected.

It is still not clear exactly how the attack happened, or what data was compromised. 

Feel free to send any tips, suggestions, story ideas and data to Ashley at ashley.capoot@nbcuni.com.