Why does the US keep running out of medicine?

The United States, the world’s richest country and its most important developer of pharmaceuticals, is not supposed to run out of prescription drugs. And yet it does — all the time.

Just in the past few weeks, there have been reported shortages of amoxicillin and Tamiflu in the midst of a surge in respiratory infections. Young patients with asthma who contract the respiratory syncytial virus (RSV) might need albuterol to ameliorate breathing problems, but that medication has been in short supply for months.

Shortages of drugs to treat all kinds of conditions are happening across the health system. There is an ongoing shortage of Adderall. Shortages of saline, morphine, and cancer drugs have occurred in recent years. When Covid-19 arrived in the United States two years ago, the country was already short on the drugs necessary for people placed on ventilators. And when I learned two months ago about shortages of Pitocin, the medication used to induce labor as well as to control bleeding from postnatal hemorrhages, Mark Turrentine, an OB-GYN at the Baylor College of Medicine, told me that these localized Pitocin shortages were “not something that happened just recently,” but had occurred repeatedly “over the past four or five years.”

According to a 2022 report from the National Academies of Sciences, Engineering, and Medicine, “on average, the number of ongoing drug shortages has been increasing and are lasting longer.” The root cause of that problem, per a report from the Food and Drug Administration, is the economics of the pharmaceutical market itself.

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