Drug shortages and price hikes have become a critical issue in the health care industry. A recent example of this occurred when a shortage of intravenous fluids and injectable opioids ensued due to manufacturing delays in the areas affected by Hurricane Maria. Another was when a drug used for toxoplasmosis, a parasite infection, had a 5,000 percent surge in price after it was acquired by a new pharmaceutical company.
To address the effects of availability and affordability on the quality and safety of health care, physicians at Brigham and Women's Hospital published a new article in the Journal of General Internal Medicine to highlight the issues and recommend potential solutions. By understanding the underlying causes, the incentives, regulations and new drug developments that the authors recommend could help to enhance competition and provide patients with reliable access to vital drugs.
For some generic drugs, the investigators state that the lack of competition stems from small market sizes, difficult regulatory requirements, and possibly unfair drug manufacturing practices. "Healthy and appropriately regulated competition protects against predatory behaviors, such as companies taking advantage of monopolies to drastically raise drug prices." said first author Karthik Sivashanker, MD, who is a psychiatrist and fellow in patient safety and quality at Brigham and Women's Hospital. "It also ensures an adequate supply of medications by promoting manufacturing redundancy."
Additionally, regulations have also played a nuanced role in influencing competition in the generic drug market. "On one hand, excessive regulation may discourage companies from entering a small generic drug market; while on the other, a general lack of oversight may open the door for price hikes and market manipulation," said Sivashanker.
Concrete solutions are necessary, and the authors insist that the problems need to be addressed collectively. Some of their suggested solutions include:
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Journal of General Internal Medicine