Changes in Drug Pricing After Drug Shortages in the United States
Authors: Inmaculada Hernandez, Shivani Sampathkumar, Chester B. Good, Aaron S. Kesselheim, William H. Shrank
Journal: Annals of Internal Medicine (2018)

Letters1 January 2019Changes in Drug Pricing After Drug Shortages in the United StatesInmaculada Hernandez, PharmD, PhD, Shivani Sampathkumar, BS, Chester B. Good, MD, MPH, Aaron S. Kesselheim, MD, JD, MPH, and William H. Shrank, MD, MSHSInmaculada Hernandez, PharmD, PhDUniversity of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (I.H., S.S.), Shivani Sampathkumar, BSUniversity of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (I.H., S.S.), Chester B. Good, MD, MPHUniversity of Pittsburgh Medical Center and U.S. Department of Veterans Affairs, Pittsburgh, Pennsylvania (C.B.G.), Aaron S. Kesselheim, MD, JD, MPHBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.S.K.), and William H. Shrank, MD, MSHSUniversity of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (W.H.S.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-1137 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Prescription drug shortages may result in substitution of less effective drugs, delays in necessary treatments, and omission of or reductions in doses (1). These shortages cause an estimated $230 million in additional costs each year (1) because of the rising prices of drugs under shortage and the higher costs of substitute drugs (1, 2).Objective: To assess the association between price changes and drug shortages across the marketplace and to evaluate how price changes differ according to the number of manufacturers that supply each drug.Methods and Findings: Using the U.S. Food and Drug Administration drug shortages database (3), ...References1. Urahn SK, Coukell A, Jungman E, Snyder E, Bournas JE, Kourti T, et al. Drug shortages: a report from The Pew Charitable Trusts and the International Society for Pharmaceutical Engineering. 2017. Accessed at www.pewtrusts.org/-/media/assets/2017/01/drug_shortages.pdf on 19 June 2018. Google Scholar2. Davies BJ, Hwang TJ, Kesselheim AS. Ensuring access to injectable generic drugs—the case of intravesical BCG for bladder cancer. N Engl J Med. 2017;376:1401-3. [PMID: 28402764] doi:10.1056/NEJMp1615697 CrossrefMedlineGoogle Scholar3. U.S. Food and Drug Administration. Drug shortages database. 2018. Accessed at www.accessdata.fda.gov/scripts/drugshortages/default.cfm on 8 July 2018. Google Scholar4. Dave CV, Pawar A, Fox ER, Brill G, Kesselheim AS. Predictors of drug shortages and association with generic drug prices: a retrospective cohort study. Value Health. 2018. doi:10.1016/j.jval.2018.04.1826 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania (I.H., S.S.)University of Pittsburgh Medical Center and U.S. Department of Veterans Affairs, Pittsburgh, Pennsylvania (C.B.G.)Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (A.S.K.)University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (W.H.S.)Acknowledgment: The authors thank Meiqi He for her help with the statistical analysis.Financial Support: Dr. Kesselheim's work is funded by the Laura and John Arnold Foundation with additional support from the Harvard Program in Therapeutic Science and the Engelberg Foundation.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1137.Reproducible Research Statement:Study protocol and statistical code: Not available. Data set: The list of drugs included in the study is available from Dr. Hernandez (e-mail, [email protected]edu), but pricing data were obtained under data user agreements and licenses that do allow for reuse. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byShortages of Prescription Drugs Due to Compliance and Quality Issues in JapanDrug purchase price volatility in an academic medical centerFrequency Of Generic Drug Price Spikes And Impact On Medicaid SpendingThe rising cost of commonly used emergency department medications (2006–15)Medication Safety in Special ContextsManagement of a parenteral opioid shortage using ASHP guidelinesRethinking supply chain management strategies for ventilator related medications during COVID-19 pandemic in the United StatesLooking Back at US Pharmacy's Past to Help Discern Its FutureDrug Shortages in the United StatesDrug Costs: What Can Infectious Diseases Physicians Do?Drug prices increase after drug shortages in USA 1 January 2019Volume 170, Issue 1Page: 74-76KeywordsDatabasesDisclosureDrug administrationDrug interactionsDrug pricesDrug usersDrugsFood and Drug AdministrationPrevention, policy, and public healthRoutes of administration ePublished: 18 September 2018 Issue Published: 1 January 2019 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...