DMU Joins Effort to Investigate Drug Shortages in the U.S. and Canada

Des Moines University Medicine and Health Sciences, in partnership with the University of Pittsburgh, the University of Toronto and the University of California - San Diego, has shared new findings from a multinational study on drug shortages in the U.S. and Canada. Published in the Journal of the American Medical Association, the study "Differences in Drug Shortages in the U.S. and Canada" provides key insights into the impact of supply chain issues on drug availability.

The research, which focused on reports of supply-chain disruptions between 2017 and 2021 in both countries, revealed that drugs with reports of supply-chain issues were 40% less likely to result in drug shortages in Canada than in the U.S.

DMU's Joshua W. Devine, Pharm.D., Ph.D., served as a collaborator in this investigation. "Drug shortages are a growing public health concern, and our study highlights the need for better global strategies to ensure access to critical medications," Devine says. "Learning from the approaches of other countries can enhance our efforts to address these shortages and ensure patient well-being."

The researchers gathered supply-chain issue reports from the U.S. Food and Drug Administration, the American Society of Health-System Pharmacists and Health Canada and compared them to actual drug usage in both countries. A drug shortage was defined as a 33% or greater reduction in monthly purchased units compared to the previous six months.

Most supply-chain issues were due to manufacturing or shipping problems, though 25% of U.S. reports did not specify a cause. Generic drugs accounted for 95% of the reports, with one in five drugs with only one manufacturer. Other factors, such as route of administration, time since Federal Drug Administration approval and drug price, did not predict shortages.

While the study didn't explore reasons for differences between U.S. and Canadian shortages, the authors note that Canada's collaborative approach between regulators, payers, manufacturers and its pharmaceutical stockpile management may contribute to fewer shortages. The authors also suggest policymakers could further incentivize production of essential but lower profit generic drugs.

"This study exemplifies DMU's commitment to addressing critical health issues through collaboration and innovation," says Pravin Mishra, Ph.D., M.B.A., executive director of research. "Partnering with leading institutions on a project of this scale aligns with our research vision to impact public health on a global level. By examining international approaches to drug availability, we can contribute to a more resilient supply chain that ultimately supports patient care and access to essential medications."

The study's results are important for public health, especially given ongoing domestic and global challenges that impact the pharmaceutical supply chain and further disrupt patient care. The research offers insights into improving drug availability and ensuring the safety and efficacy of pharmaceuticals in both countries.

Lead author Mina Tadrous, Pharm.D., Ph.D., of the University of Toronto, and senior author Katie J. Suda, Pharm.D., M.S., of the University of Pittsburgh School of Medicine, collaborated with several contributors. These include Katherine Callaway Kim, M.P.H.; Scott D. Rothenberger, Ph.D.; Tina B. Hershey, J.D., M.P.H.; Lisa M. Maillart, Ph.D.; and Walid F. Gellad, M.D., M.P.H., all from the University of Pittsburgh. Additional contributors are Inmaculada Hernandez, Pharm.D., Ph.D., from the University of California San Diego, and Joshua W. Devine, Pharm.D., Ph.D., from Des Moines University Medicine and Health Sciences.

This research was supported by the Agency for Healthcare Research and Quality (R01 HS027985). Outside of the reported work, Dr. Hernandez has received consulting fees from Bristol Myers Squibb and Pfizer, and Dr. Tadrous received consulting fees from Health Canada.