The Pitt Prescription | Ongoing medication shortages give patients a bitter pill to swallow

The Pitt Prescription is a biweekly blog where student pharmacist and senior staff writer Elizabeth Donnelly provides tips on how to stay healthy in college. This edition was reviewed by Karen Pater, PharmD., CDCES, BCACP.

By Elizabeth Donnelly, Senior Staff Writer

If you’ve spent any amount of time in a pharmacy recently, you’ve probably seen signs or heard a pharmacist talking about the ongoing national medication shortages.

Drug shortages are not a new phenomenon. However, over the past year, the shortages reached a five-year record high. The U.S. Senate Committee on Homeland Security and Governmental Affairs recently released a report at the beginning of March detailing the current status of drug shortages within the U.S. This document reported that at the end of 2022, drug shortages experienced a record five-year high of 295 active shortages.

Medication shortages may leave thousands of patients without access to essential medications necessary to maintain their health and well-being. Recently, some of the most prolific shortages include stimulant medications for attention deficit hyperactivity disorder (ADHD) and medicine for diabetes and obesity, like semaglutide (known by the brand names of Ozempic and Wegovy). Shortages have even affected some common medications, from children’s fever reducers to simple antibiotics like amoxicillin, causing drug stores to ration their available stock.

These shortages often result in delayed treatments, increased healthcare costs and — in some cases — serious health consequences for patients who cannot access their necessary prescriptions.

For example, patients who rely on Ozempic for the management of their diabetes have been at the forefront of the groups affected by the current shortages. The FDA approved semaglutide under the brand name of Ozempic in 2017 for the treatment of type 2 diabetes. More recently, the FDA approved semaglutide under the brand name of Wegovy in 2021 for chronic weight management in adults with obesity. Novo Nordisk manufactures both Ozempic and Wegovy, which contain the same active ingredient, semaglutide, but are used at different doses for the two approved indications.

This semaglutide shortage is a multifaceted issue. As with other ongoing drug shortages, there have been significant disruptions in production and in the supply chain, which the COVID-19 pandemic heightened. In the case of Ozempic and Wegovy, a notable feature of this shortage is the sharp increase in demand for the products. Though initially approved for the treatment of type 2 diabetes, the injectable semaglutide medication has shown promising results for weight loss.

As news spread about the benefits of semaglutide for losing weight quickly, celebrities and internet influencers quickly picked up what they considered to be a “miracle” drug. Semaglutide became well-known on the internet, even prompting a TikTok trend where people show off their bodies before and after using Ozempic. This internet fame further increased the demand for semaglutide at a time when it was already in short supply due to manufacturing disruptions, resulting in the current prolonged shortage.

In addition to the semaglutide shortage, stimulant medications used to treat ADHD, like Adderall — also known as amphetamine/dextroamphetamine — are in short supply nationwide. This particularly affects college campuses, where it is estimated that students with ADHD make up roughly 6% of the student population. For Pitt, that would equate to almost 1700 students with ADHD, over 800 of whom are registered with Pitt’s Office of Disability Resources and Services.

Similarly to semaglutide, supply chain issues and an increase in demand are to blame for the nationwide shortages of ADHD medications. Experts theorize that ADHD symptoms worsened for many individuals during the pandemic, thus resulting in an increase in new prescriptions for stimulant medications. Further, the U.S. Drug Enforcement Agency (DEA) controls the supply of Schedule II drugs, and they have not increased manufacturing quotas to meet the increase in new prescriptions. This leaves patients with new or already existing prescriptions scrambling to find a pharmacy that has their ADHD medication in stock.

With this in mind, it is important to note that nationwide drug shortages are never the fault of pharmacists or pharmacy employees. Pharmacists are essential healthcare workers who work tirelessly on the front lines to help patients obtain their necessary medications. There is a lot of work that goes on behind the scenes in the pharmacy, with pharmacists ensuring all prescriptions are medically accurate, contacting prescribers when prescriptions contain errors and contacting insurance companies to assist with financial access to medications.

Pharmacists are medication experts, and they work diligently to manage their inventory while assisting patients, but these drug shortages still occur due to factors far beyond their control. If you find yourself unable to get your medications due to a backorder or shortage, compassion goes a long way. If you are respectful towards the pharmacist and pharmacy staff, they will do everything in their power to help you find alternative solutions — and sometimes, unfortunately, there is no solution.

If a medication shortage ever affects you, there are a few things you can do. First, politely communicate with the pharmacist to see if they have any information regarding when more stock will arrive. If they are not sure, which is often the case due to the unpredictable nature of shortages, there are two options. The first is to contact different pharmacies in your area to see if they have your medication in stock. Secondly, you can contact your provider to see if they can change the medication or the dose to a suitable alternative.

Through open communication, both patients and healthcare providers can work collaboratively to ensure that patients are receiving necessary medications, even in the event of shortages. It’s important for patients to realize that pharmacists are there to help and are attempting to provide the best care possible during these challenging and uncertain times.

Elizabeth writes primarily about self-care and pharmacological topics. For questions, comments or concerns, you can reach her at [email protected].