The Economics Of Drug Shortages
Supply and demand are economic principles that govern the availability and price of goods and services in a market economy. Applied to the pharmaceutical landscape, market forces drive price and product availability, but when disequilibrium strikes, drug shortages can be disruptive, affecting patients in various ways. Shortages can also stem from manufacturing and supply chain challenges, raw material limitations, and regulatory constraints. This dynamic environment necessitates innovative solutions where compound pharmacies play a vital role. Compounding pharmacies are critical in maintaining drug availability when levels become critically low by customizing medications and offering formulations tailored to specific individual needs. Drug shortages are made public through the Food and Drug Administration (FDA) database, which typically only reports medications that are considered medically necessary and have the potential to impact public health.
Dangers of drug scarcity
Drug shortages can lead to disturbances and discontinuity in patient care from treatment delays and suboptimal alternatives. This is often highlighted by drug preparations that are sole source products without generics or biosimilars. These interruptions in availability can lead to worsening health conditions and outcomes, risks of complications, and potentially life-threatening situations. Shortages can also lead to the utilization of less effective or experimental options, further exposing patients to greater risks and adverse side effects. Oftentimes, experimental alternatives can strain healthcare budgets and create further financial hardship for patients. Compounding pharmacies provide a critical buffer against these risks, furnishing a solution to access customized medications when commercially available supplies are limited or unavailable.
What are compound pharmacies?
Traditional pharmacies primarily dispense commercially manufactured medications at fixed dosages, concentrations, and amounts. Compound pharmacists, on the other hand, have advanced training and specialization in creating customized drug formulations in specific strengths and dosages that are free of allergies, dyes, and additives. In addition, compounding requires expertise in regulations outlined in the US Pharmacopeia (USP), which dictates sterile and nonsterile compounding procedures. This specialized practice requires a deep understanding of active pharmaceutical ingredients (API), the main biologically active chemical components that produce the desired therapeutic effect to treat disease, and inactive compounds, or excipients, that aid in delivering the API to the desired target.
Compounding meets the skyrocketing demand
GLP-1 receptor agonists and hormone replacement therapy (HRT) medications represent 2 classifications of drugs that have experienced a growing national surge leading to shortages. GLP-1s, primarily researched and marketed for type 2 diabetes (T2D) management, have gained popularity for weight loss, cardiovascular, and obstructive sleep apnea (OSA) benefits. HRT, used to manage vasomotor symptoms associated with menopause and hormone deficiencies, has gained popularity as a means of mitigating symptoms during this transitional period. With searching demand, shortages have been filled through compounding tailored medications, ensuring patients receive access to necessary treatments and minimizing disruptions in continuity of care.
The vital role of compounding pharmacies
Drug shortages, driven by market forces, manufacturing issues, and increased demand, engender a substantial threat to patient care, disrupting treatment plans and leading to suboptimal health outcomes. Common pharmacies provide a critical solution to this ever-growing need, creating customized medications that suit individual preferences when commercially available drugs are unavailable. These specialized pharmacies are equipped with the expertise and knowledge to formulate medications in unique dosages, concentrations, and combinations, often not obtainable commercially. During times of great demand, as illustrated by GLP-1 and HRT therapies, compounding offers an indispensable solution, ensuring patient care is minimally disrupted and outcomes preserved.
