Drug shortages in the United States have reached crisis levels. The Food and Drug Administration reports that nearly 140 medicines are currently in short supply. That figure includes more than a dozen cancer drugs, which has forced doctors and patients to confront the dangerous possibility of rationing.
These shortages threaten the lives of thousands of Americans and the health of many more. Yet policymakers cannot seem to agree on a cause or solution. Some have blamed supply chain bottlenecks and quality concerns at overseas manufacturing plants. Other lawmakers think that giving the FDA new powers, like requiring drugmakers to report spikes in demand, is the answer.
Yet in the midst of all this debate and finger-pointing, policymakers have largely overlooked one of the key causes of the crisis — the increasing power of pharmacy benefit managers, or PBMs.