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Drug shortages are spreading. Your medication may be next.

Drug shortages in the U.S. are at the highest level in nearly a decade. The shortages are affecting treatments for cancer patients, kids with ear infections, pregnant women, ADHD patients and others.

“There were 309 active, ongoing drug shortages — the highest number in nearly a decade and close to the all-time high of 320 shortages” at the end of the second quarter, according to a recent study.

Americans may be aware of the shortages, if they take a medication that’s hard to get, or if a shortage hits the headlines like last winter’s reports of scarce antibiotics and fever and pain relievers for children. But it turns out that the shortages are fairly widespread, resulting in a lot of people not getting medications, and extreme treatment decisions. Among those affected:

  • An oncologist who had to decide who’s getting the cancer drug today — “is it the 20-year-old with testicular cancer or the 28-year-old with lymphoma?” one doctor told us.
  • Kids needing antibiotics for ear infections — and who have developed antibiotic resistance because common drugs are hard to get.
  • Pregnant women needing Pitocin to induce labor — and premature babies needing specialized feeding formula and supplements. And the list goes on.

“But are they going to tell the patients? No. And the reason they’re not going to tell the patients is because you don’t want to scare your patient — they’re under enough stress,” one doctor told us.

One doctor told us:

“I had a colleague that had two very, very sick patients come in at the same time. One was a child with a bad asthma attack. The other was a patient with chronic obstructive pulmonary disease. Those two patients both need the medication called albuterol, your go-to medication to open up lungs that are obstructed.

“They ran out of albuterol. One patient got sent to the ICU and got an inferior drug, and the other one got transferred to another hospital because they had to make a choice.”

“You can’t breathe and you can’t get what you need. Are you kidding me?”

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Hospital buys saline from vet clinic and more: U.S. drug shortages, revisited

But wait, it gets worse:

  • A hospital buying saline solution bags from a veterinary hospital.
  • A vet hospital that can’t get saline bags because it’s “last in line.”
  • One doctor told us said they often get warnings from hospital leadership about medication shortages: “This week you won’t have this, so you need a workaround. And then we have to remember which directive is in effect.”

This takes time, he said — and time is valuable when a patient is in crisis. It’s also wearing.

“If you have to change for a medical reason that’s fine,” he said of switching medications. “But if I have to override to something that frankly is inferior — it wears a mind down. You go slower, you’re more depressed, you’re frustrated and snappy.”

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Ritalin, Adderall and Vyvanse: The stimulant shortage expands

The shortage of stimulant medications like Adderall has, perhaps predictably, exploded into shortages of similar medications like Ritalin, Vyvanse, Concerta and others — causing havoc for patients, including one woman who called nearly 100 drugstores in one day in an attempt to fill her prescription.

Adderall, a stimulant approved to treat Attention Deficit Hyperactivity Disorder (ADHD), has been hard to get consistently for some time now.

The Adderall shortage, which began last year, is partly demand-driven and partly a manufacturing problem. Adderall prescriptions rose more than 30 percent over the past five years and accelerated during the pandemic. Telemedicine during the pandemic drove demand.

On top of increased demand, and some supply-chain and labor shortage issues at manufacturers affecting some production lines, a secret 2021 settlement in an opioid case with three top U.S. drug distributors kicked in to make more limits on controlled substances. People nationwide are struggling to consistently fill prescriptions

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Hospice regulators announce crackdown

Regulators plan disciplinary actions that could affect as many as 400 hospices that are profiting from fraud and unsound business practices, the Centers for Medicare and Medicaid Services announced recently. Hospices, which provide end-of-life and palliative care for dying people, have increasingly become targets for purchase by private equity investors, who view them as cash…

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Arkansas hospital sued thousands of patients over medical bills in the pandemic, including its own employees

As Covid cases spread in 2020, visitors to the University of Arkansas for Medical Sciences were greeted by a colorful sign put up by grateful neighbors outside the university’s medical center: ‘Heroes Work Here,’” Casey Tolan and Ed Lavandera write over at CNN. But the hospital sued patients, including its own employees, for non-payment of bills …

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What we’re reading

Medicare’s affordability burden: Medicare and Medicare Advantage, compared. Commonwealth Fund.

F.T.C. warns pharma companies that it may go after them for faking patent listings to discourage competitors and protect profits. But will penalties be real, or just a slap on the wrist? Techdirt.

F.T.C. sues Anesthesia Partners and its parent, Welsh Carson, Anderson and Stowe, accusing them of forming a monopoly to drive up prices. Stat News.

Biden Administration to ban medical debt from credit scores. KFF Health News.

C.M.S. tries to insure that children disenrolled from Medicaid are protected. Georgetown University McCourt School of Public Policy.

Medicare Advantage marketing analyzed. To no one’s surprise, it’s found to be misleading. KFF.

1 in 4 immigrants say they’ve been treated unfairly by medical professionals in the U.S. KFF.

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Jeanne Pinder  is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded...