A Nuffield Trust report cited in the documents found that medicine supply problems doubled since 2020.

The American Society of Health-System Pharmacists reported that more than 250 medications were on the US shortage list and described 2023 as the worst year for shortages in about a decade.

Examples of affected medicines include antiepileptic drugs and ADHD medications, which patients and clinicians reported as frequently in short supply.

Ireland experienced shortages of prescription paracetamol during a winter surge of COVID-19 and flu, and some suppliers expected resupply in January 2023.

News reports listed chemotherapy agents, Adderall, lidocaine, and amoxicillin among medications on shortage lists.

Documented causes included manufacturing and quality problems, production delays and discontinuations, shortages of raw materials, industry consolidation, and failures in procurement and timely payments.

Shortages pushed up drug prices, with the US Department of Health and Human Services reporting a 16.6% price increase for drugs involved in shortages and some alternatives costing at least three times more.

Health systems coped by switching patients to alternative strengths or brands, advising consultation with pharmacists, checking national shortage lists, using discount programs, and hospitals negotiating bills or offering discounts.

Reports recommended improving budgeting and forecasting, reforming procurement and payment processes, enhancing coordination among stakeholders, and shared responsibility by government and industry to secure supplies.

Conclusion: Medication shortages increased in 2021–2024, affected many essential drugs, and were driven by manufacturing, supply-chain, and financing failures; health systems relied on alternative products, financial measures, and procurement reforms to cope.

A Nuffield Trust report cited in the documents found that medicine supply problems doubled since 2020.

Title:

Content: Is a prostate issue to blame for my sexual problems after I started online dating aged 76 following divorce? Ask DR ELLIE CANNON

Q: I’m a healthy 76-year-old and I just started online dating after my divorce. However, during sex I struggle to maintain an erection. Also when I climax, I experience a pleasurable feeling but produce nothing. Should I be worried about my prostate?

Dr Ellie replies: Men often experience sexual problems later in life because of an enlarged prostate or its treatment. The prostate is a small gland at the base of the bladder around the tube that carries the urine out. It is often described as being the size of a walnut, but as men age, it can become much larger than this.

Regular exercise, quitting smoking and cutting down on alcohol have all been shown to help combat erectile dysfunction

Of course, men can also get prostate cancer. An enlarged prostate will make it more difficult to urinate, due to the proximity of the prostate to the bladder, and trigger sexual problems.

These issues are typically erectile dysfunction and difficulty ejaculating. There are treatments which can combat an enlarged prostate, but it’s important to know that these too can lead to sexual problems.

READ MORE: DR ELLIE CANNON: Are the drugs I'm taking to blame for my hip pain?

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One commonly used medication for prostate problems is called finasteride, a daily tablet which can make it easier to pee.

However, more than one in 100 men who take it will have problems getting an erection and or problems ejaculating.

Men who don’t respond to medication are often offered a transurethral resection of the prostate – known as a TURP – which involves cutting away sections of the prostate.

It is thought that as many as three-quarters of men who receive a TURP will have difficulty ejaculating due to damage to the nerves and muscles in the prostate region.

Likewise, surgery to remove the prostate often leads to dry orgasms – where nothing comes out – as the gland is involved in the production of semen.

There are things you can do yourself to reduce the severity of your symptoms.

Regular exercise, quitting smoking and cutting down on alcohol have all been shown to help combat erectile dysfunction.

If the problem continues – or gets worse – then you should talk to your GP about treatment.

Q: I’m a woman in my late 70s. In 2018 I was prescribed alendronic acid after I had a fall and fractured my wrist. I have heard that you should take a break from this medication after five years but my GP says I should stay on it. I also requested another bone density scan but she said I didn’t need one. Is this correct?

Dr Ellie replies: Alendronic acid is the medication we most commonly use for the bone-thinning condition osteoporosis, and it is usually safe to take long-term.

It is taken as a weekly tablet or drink and reduces the risk of further breaks. Our bones are constantly being broken down and rebuilt by specially adapted cells within them. Osteoporosis occurs when there is too much bone breakdown happening which causes them to weaken. Alendronic acid slows down this process. Usually after five years on the treatment you would have a review of your medication to decide if you still require it. This would often involve a bone density scan, also known as a Dexa scan. A patient may stay on the medication for another five years or take a ‘treatment holiday’ and come off it for a few years.

Alendronic acid does have some common side-effects including constipation, dizziness and headaches

Alendronic acid does have some common side-effects including constipation, dizziness and headaches.

If the treatment is causing too many problems, or is failing to keep the osteoporosis under control, patients might be offered a new drug. However, it is hard to make this decision without a further Dexa scan.

The Royal Osteoporosis Society offers excellent support – you can speak with one of their specialist nurses on 0808 800 0035. After this, it would be worth requesting a conversation with the GP to establish why your medication is being continued.

Q: My GP advised I take statins, but ten days after I began the pills I developed serious pins and needles in my feet and hands. I immediately stopped taking the drug, but two months later, the pins and needles have turned into a painful stabbing sensation all over my body. My feet feel like they are burning.

Despite this, my GP refuses to see me for an appointment because he says it is a matter for a pharmacist. What should I do?

Dr Ellie replies: This is not the standard of care someone should be receiving from an NHS GP. Anyone with new symptoms or potential medication side-effects should be offered an appointment.

It might be worth looking into registering at a new practice, so you can get easier access to a doctor. Pins and needles are an uncommon side-effect of statins. The fact the sensation has continued after you stopped taking the pills could suggest it is unrelated. A feeling of electric shocks or burning, particularly in the feet, can be a condition called peripheral neuropathy where the nerves are not working properly. Peripheral neuropathy is often triggered by a vitamin B12 deficiency, and can be reversed. This is why it is crucial that you see a doctor.

If it is the statins, a GP can recommend other ways of treating cholesterol such as diet and lifestyle changes, or other medicines.

DRUG SHORTAGES PUT PATIENTS AT RISK

Medicine shortages are worse than ever, and are now affecting people’s health, according to a new report.

Supply problems have doubled since 2020, the Nuffield Trust think-tank found. GPs and pharmacists deal with this daily.

I do not recall shortages like this even being an issue

ten years ago.

Medicines for epilepsy are often in short supply. Without these, seizures are more likely and can be catastrophic. And I know parents who drive to many pharmacies to find ADHD drugs for their children.

If you have a practice pharmacist at your GP surgery, try to ask them if there are shortages of your prescription drugs, and whether alternatives can be had.

Doctors tend not to know what is and isn’t available.

Are you struggling to get hold of vital medication? Write and let me know.

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Back pain sufferers are being fobbed off

Latest figures suggest a staggering 2.8 million Britons are ‘economically inactive’ due to ill health.

That’s double the number of ten years ago — and includes a rise of almost three-quarters of a million since the pandemic. This is probably because getting treatment for even serious problems is so difficult now.

Mental illness and respiratory diseases top the list of reasons for going long-term sick. The other most common is ‘musculoskeletal problems’, often back trouble. But back pain can be resolved quickly with advice, exercise and a physiotherapy assessment.

It frustrates me that, even if I refer my patients for the latter, it’s just not available — they’re fobbed off with phone appointments and leaflets. Have you struggled to get help with your back pain? Write and let me know.

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk

Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.

The American Society of Health-System Pharmacists reported that more than 250 medications were on the US shortage list and described 2023 as the worst year for shortages in about a decade.

Title:

Content: Prescription drug shortages lead to higher prices

Reporter: Andryanna Sheppard
Published: Updated:
Lea este artículo en Noticias WINK

Millions of people in the United States depend on prescription drugs to manage pain, treat medical conditions, and even to help them stay alive. However, the country’s drug shortage is making it hard for some people to get the medication they need or pay for the drugs that are available.

Federal Drug Administration data shows 90 percent of prescriptions in the US are for generic drugs. According to the National Institutes of Health, most prescription drugs involved in shortages are generic options.

There are currently more than 250 medications on the nation’s prescription drug shortage list, according to the American Society of Health-System Pharmacists. The organization says 2023 marked the worst year for shortages in about a decade.

Jessica Kahn’s two sons were diagnosed with ADD.

“I would say tricky, tricky to navigate,” Kahn described.

For the past year, Kahn said getting their medication has been frustrating.

“I have my list of all the pharmacies. I’ve even driven all the way up north to Walgreens or a CVS, some random place to go pick up a kids’ prescription,” Kahn added.

According to the FDA, prescription drug shortages are often linked to manufacturing and quality problems, delays, and discontinuations. Two drugs used in chemotherapy, Adderall, lidocaine, and amoxicillin are just a couple of the prescription medications on the shortage list.

When drug supplies are low, prices tend to increase. According to the US Department of Health and Human Services, there is a 16.6 percent increase in the price of drugs involved in a shortage. And in some cases, alternative drugs were priced at least three times higher.

“You got to be very conscientious that it might not be available and that it is not an option,” Kahn advised. “No matter how many places you call, it’s not there.”

Beating the prescription drug shortage

Health experts offer these tips:

  • Check the national drug shortage list for your medication and possible alternatives.
  • Don’t wait until your prescription is almost gone to refill it.
  • Check other pharmacies for availability and if you can’t find the generic version, look for coupons or programs that offer payment help. Some patients have reported that they receive additional help to reduce some prescription costs from $100 to $10, it’s not allowed if you are already on Medicare.
  • Websites and apps like GoodRX, RX Saver and WellRX can help you find the cheapest place that has your medication and coupons for it.

Contributors to this news report include: Lindsay Dailey, Producer; Bob Walko, Editor

Copyright ©2024 Fort Myers Broadcasting. All rights reserved.

This material may not be published, broadcast, rewritten, or redistributed without prior written consent.

Examples of affected medicines include antiepileptic drugs and ADHD medications, which patients and clinicians reported as frequently in short supply.

Ireland experienced shortages of prescription paracetamol during a winter surge of COVID-19 and flu, and some suppliers expected resupply in January 2023.

Title:

Content: Ireland has been suffering a paracetamol shortage as cases of Covid-19 and the winter flu in the country soared over the festive and new year period.

The revelation was made by Health Minister Stephen Donnelly after his department received notification of a supply issue from the Health Products Regulatory Authority.

It is understood the shortage impacted some prescription paracetamol products.

Read More:Irish people complain of ‘worst ever’ winter bug sweeping country that feels like Covid but isn’t

Two suppliers affected have stated that resupply will be sometime in January 2023.

However, there are other prescription paracetamol suppliers with some stock available on the shelves.

Paracetamol is one of the medicines used most often in Ireland and especially for the flu, aches and pain.

But Mr Donnelly pointed out that there are multiple forms of the drug with different strengths and brands available from various sources.

He said: "In the event that there are some supply issues for individual medicines, alternative options such as alternative strengths and brands, generic medicines will usually be available to ensure continuity of treatment.

"In some cases where the medicine initially prescribed for the patient is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional."

The Health Minister said medicine shortages have been increasingly prevalent worldwide over the past decade. The causes of such shortages are multifactorial including shortage of raw materials, manufacturing difficulties and industry consolidations.

He stated: "Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways as the supply models and clinical use of therapies can vary across national health systems.

"Management of medicines shortages necessitates a multi-faceted, multi stakeholder response to ensure patient safety , continuity of care and protection of public health.

"Patients or their carers who have any concerns in relation to temporary alternative products provided because of medical shortages are advised to speak with their pharmacist or other healthcare [professionals] involved in their care."

Mr Donnelly was responding to a number of written Dail questions on the shortage of medicines.

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News reports listed chemotherapy agents, Adderall, lidocaine, and amoxicillin among medications on shortage lists.

Documented causes included manufacturing and quality problems, production delays and discontinuations, shortages of raw materials, industry consolidation, and failures in procurement and timely payments.

Title:

Content: Lack of medicines in MOH hospitals and accumulation of indebtedness Repercussions / solutions
3 hours ago
Dr. Naeem Malkawi
The problem of shortage of medicines in Jordanian hospitals requires quick and effective attention and intervention, as providing medicines to patients is one of the foundations of quality health care and one of the most important strategies of the Ministry of Health, however, the shortage of medicines in many hospitals leads to health, economic and social challenges that threaten the quality of health care and patient safety.
The budget of the Ministry of Health of medicines, vaccines, vaccines and medical consumables for this year 2023 was estimated at 103.75 million dinars, where the actual for the past year 2022 was 93.8 million dinars.
The question is, how did the Ministry of Health accumulate such a large indebtedness in the item of medicines to reach 300 million dinars for pharmaceutical companies?
And why last week was the debt of 2019 cleared and deducted estimated at 50% of the debt for that year?
This means that there is still a delay in the payment of dues for companies for the years 2020, 2021 and 2022 in addition to eight months of the current year 2023, and this brings us to a range of reasons and challenges:
1.
The aim of the Ministry of Health was to reduce the bureaucracy of procedures and overcome the complexity of procurement references in hospitals and health directorates in the governorates and not to obtain price and discount preferences, but the results indicate a defect in the management and mechanism of dealing with the strategy of unified and central procurement, despite the margin for hospital administrations to use the power of direct purchase in cases of necessity.
2.
Preparation of sub-budgets for hospitals: Evidence shows that there is a problem in the preparation of sub-budgets for hospitals and the main budget of the Ministry of Health with regard to the item of medicines, which is due to the lack of accurate and sufficient data on the number of patients and hospital needs of medicines, and the lack of accurate forecasting of future needs.
3.
Delays in the review of financial claims and invoices between the Ministry of Health and the hospitals on the one hand and the pharmaceutical companies on the other hand, is one of the most important reasons behind the accumulation of indebtedness, and this negatively affects the liquidity of the pharmaceutical companies and hinders them from providing a sustainable service in adhering to the procedures of supplying medicines according to schedule.
4.
Lack of coordination and communication: There may be a lack of coordination and communication between hospitals, the Ministry of Health and pharmaceutical companies, which complicates the supply and distribution of medicines and increases the chances of delays and the depletion of medicines from hospitals in the absence of an effective policy for stock management and the time required for stock adequacy.
5.
Focusing on the trade names of certain drugs from specific production sources and not adopting the protocol of writing the scientific name for the prescriptions of patients.
6.
One of the reasons that may be major and important at the same time is the funding aspect and the lack of the necessary allocations or use them in other aspects other than medicines to fill a deficit or emergency during the use of budget items due to the scarcity of available liquidity. Medication.
Lack of medication can lead to:
1.
Threat to patient safety: Lack of medication puts sick people at risk, as this can lead to delays in receiving necessary treatment or the unavailability of vital drugs, putting their lives at risk.
2.
Economic Implications: The lack of medicines entails additional economic costs for the health system and patients.
Medical cases may be referred to other medical centers or private hospitals, increasing pressure on other MOH budget items.
3.
Pressure on health care workers: Health care workers are under pressure as a result of dealing with patients affected by drug shortages and repeatedly facing their inquiries and complaints.
4.
Social repercussions:
Increased anxiety and stress: A lack of medication can lead to an increase in anxiety and stress among patients and their families, as they live in uncertainty about the availability of the necessary treatment.
Lack of medication can affect the level of trust in the health system among citizens, who may feel that the system is unable to provide them with adequate health care.
Increased costs and social burdens: Some patients may have to incur additional costs to obtain drugs from other sources outside hospitals, affecting their financial and economic status.
After all this narrative there must be ways to overcome these dilemmas:
1.
Preparation of budgets scientifically and professionally: Hospitals should develop more accurate standards for the preparation of sub-budgets for medicines, through the analysis of previous data, estimation of future needs and other scientific and methodological foundations in the preparation of budgets and commitment to apply them accurately.
2.
Improve coordination and communication between parties: Coordination between the Ministry of Health, hospitals and pharmaceutical companies should be strengthened through the establishment of structured mechanisms for information exchange, review of invoices, and completion of claims, and not delay them.
3.
Implementation of fiscal reforms: The Government and the Ministry of Health should implement fiscal reforms that provide funding to cover this important item and pay dues in a timely manner, reduce bureaucracy in the financial audit process, and proceed with payment procedures within the timetable mechanism agreed in the tender terms.
4.
Achieving social responsibility: The government and pharmaceutical companies should adopt a social responsibility towards patients by providing these drugs and reducing their prices in the market to make them more accessible to patients while relieving part of the pressure and burden on hospitals.
Addressing the problem of drug shortages in government hospitals requires comprehensive cooperation between all concerned parties from government, Ministry of Health, hospitals, drug suppliers and patients.
To provide medicines on a permanent basis and to ensure the provision of high quality health care to the Jordanian patient.

Shortages pushed up drug prices, with the US Department of Health and Human Services reporting a 16.6% price increase for drugs involved in shortages and some alternatives costing at least three times more.

Health systems coped by switching patients to alternative strengths or brands, advising consultation with pharmacists, checking national shortage lists, using discount programs, and hospitals negotiating bills or offering discounts.

Title:

Content: …As drugs prices skyrocket, many now out of reach

Hospitals, patients, pharmacists groan, fight for survival

By Cosmas Omegoh

Are crises looming in the healthcare sector at the moment? The answer is in the affirmative. And there are chances that such crises are in the multiple, as indications suggest. That is the reality before everyone, although many are yet to realise it until they fall sick.

Now, take a walk down the road; stroll into that next-door pharmacy shop. Then ask the pharmacy attendants about the price of the drug you purchased the last time, about three months ago. The price must have changed unarguably considerably. Its current price tag is sure to send you screaming in shock.

And then walk into a hospital in that neigbourhood and ask to be treated for that minor ailment. You will be dazed by the bill you will be handed down  afterwards.

The reality right now is that most people who have one thing or the other to do with the healthcare sector is groaning and lamenting. Every patient currently weaving in and out of hospital at the moment in search of wellness is complaining.

Just as it is in many other sectors of the economy, so it is in the drug industry where things are particularly steadily falling apart.

Now, here is what a recent Sunday Sun investigation revealed: those in the drug supply chain are bitterly complaining that their customers now can hardly afford the prices of drugs.

Health workers on their part are worried that only a handful of their patients are becoming barely able to pay for their hospital bills. The former are feeling embittered, fearing that their facilities might collapse with time as a result of lack of patronage, revenue and job losses.

Now, experts fear that patients might be becoming sicker. Because of sharp increases in the cost of drugs and hospital bills, a lot more people might either be resorting to self medication when they are ill, or falling back to the traditional way of treating themselves.

However, a healthcare expert, Dr Abayomi Ogunbekun, believes that the situation will ease off with time. But for now, his fears are definite: that in the interim, the current regime might result to “high morbidity and high mortality.”

He said that if the situation persists, many more people might begin to fall sick more easily and then die.

Analysts insisted that the current hardship in the country and people’s inability to meet up with their needs, are coming on the margin of sweeping policies recently introduced by the current central administration.

Following, for instance, the “subsidy is gone,” declaration by President Bola Ahmed Tinubu in his inauguration speech, petrol prices is now hovering between N500 and N700 depending on one’s location, up from N185. Consequently, a considerable number of people are now spending far more of their income buying fuel and paying transport fares. The latter had soared highly on every route lately. Therefore, transportation is now taking out a large chunk of people’s earnings.

Besides, the recent merger of the official and parallel foreign exchange windows is seeing the Naira exchanging well above N800 with the dollar – a move experts suggest has forced a devaluation of the local currency. That is already driving prices of goods and services to the sky.

Then, there is also the hike in electricity tariff. Consumers are now forced to pay higher amounts for the electricity them consume.

Those who know insist the government’s recent policies are pushing up price and forcing the ordinary persons into multi-dimensional poverty. That most people now care much more about what to eat than anything else, with concern about their health taking the backburner – because they can no longer afford the high cost of drugs and hospital bills as much as they used to in the recent past.

Drug prices on the rise

While reflecting on the ongoing trend, a community pharmacist, Mr Damian Izuka, described the current soar-away prices of drugs in the Nigerian market as worrisome.

“We are in a moment of inflation. The price of everything now is going up; since the price of every commodity is rising, those of drugs will not be an exception. That is pure elementary economics,” he explained.

While maintaining that his colleagues in the industry are not to be blamed, he said: “The increases in the prices of drugs are not the making of any pharmacist or drugs supplier. Not at all! It is brought about by the reality of the economic situation we now face.

“Everyone knows that the cost of the dollar to the naria is up there in the clouds. And now, it is inching towards the N900 mark, with clear indication for everyone to see that towards the end of the year, it will hit N1,000. Everything seems to be heading up to the sky. Therefore, what will happen is that because we are majorly a consuming nation, prices will continue to go up until we realise the need to look inwards and do what other nations who are doing well are doing. Unless we do that, inflation will continue to bite harder.”

Fears over cost of drugs

Izuka who is a Fellow of Pharmaceutical Society of Nigeria (PSN) is unhappy that the country might be headed for the untoward if nothing is done soon to address the rising cost of drugs.

He said: “I have this fear that what we are in now might snowball into a big crisis.

“To be honest with you, drugs are not luxury products. They are products related to wellness.

“You are sick, you are not feeling fine. Then you go for drugs; they kick in to challenge the illness and you are well again.

“Now, when the prices of those drugs go up and become unreachable to the ordinary person, I cannot imagine what will happen next.

“To tell you the truth, I pity the ordinary man in this country. I imagine the fate of the poor who will be needing drugs at such high prices. Everyone needs drugs to get well. If, therefore, they become not affordable, it will be very bitter, very unpleasant.”

Another community-based pharmacist in Lagos, Nike Abioye, also lamented the rising cost of drugs in the market.

She too revealed that some drugs which used to be fairly affordable earlier were no longer so.

“The last time I went to restock our outlet, the prices I was hearing surprised me; when I asked for (a certain antibiotic), I was told its recent retail price had hit N19,000 per pack.

“I wondered who on earth would buy it off the shelf if I purchased it.

“It was better I bought other lesser drugs which the people could afford than to tie such huge amount of money on a product no one would be ready to touch with a long pole.”

Patients lament drug cost

Also lamenting, Mr Tolu Olajire recalled that he was stunned by the high cost of drugs he was asked to purchase after a visit to a General Hospital in Lagos, stating: “We are seeing the worst of times.

“My son was having this illness which we kept treating at home; we kept buying drugs from the local shop in our area, but they couldn’t cure him.

“When we eventually visited the General Hospital, the doctor wrote drugs for him some of which we were to purchase because they didn’t have them all at the hospital   pharmacy.

“I was only able to buy the quantity the money I had could fetch so that he could start taking until I could buy more.”

Olajire said that he only had to take his child to the hospital because he felt that his ailment was attaining the level that could not be managed at home.

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“For me, local concoction (agbo) is the answer. It is either I buy the cooked stuff from the local vendor or I source the leaves and roots by myself, cook and drink.”

Then he asked: “With the high cost of hospital bills and drugs nowadays, how can we cope?”

In like manner, Mrs Agbo, a resident of Isheri-Oshun, Lagos, told our correspondent that her family and many others in her neigbourhood now depend on the services of a retired nurse in their area for treatment.

“She is our own doctor in this area – our saving grace – popular and kind too.

“Many families depend on her for their wellness.

“The hospitals in this area are very expensive. If not her, I wonder how many will be surviving this hard times.”

Drug cost impact on treatment, hospitals

Dr Ogunbekun who works for Hoarse Memorial Methodist Hospital, Yaba, Lagos, recalled that the ongoing drug crisis in the country was hitting the hospitals.

“Indeed, drugs are very, very expensive these days. The cost of things has gone up astronomically.

“But we have continued to cope.”

Dr Abayomi who is the chairman of Christian Health Association of Nigeria (CHAN), Lagos State chapter, admitted that “the true situation now is that the practice of medicine is beginning to encounter hiccups. People no longer have money to pay for their medical bills.

“Right now, our staff are demanding pay rise. Many are running away, going abroad for greener pastures. Those who are still around, if you don’t give them a better package they walk away.

“Indeed, the cost of medical treatment is skyrocketing. Now, many increasingly can’t  afford it. If you charge the way things are, not many will be able to pay except the billionaires in our midst.

“Now, if we insist on charging highly, we will end up scaring away our patients. Yet, we need to stay afloat to be able to pay our staff’s salaries.”

Dr Ogunbekun affirmed that “things are really terrible in Nigerian now. The cost of transportation alone is consuming above 80 per cent of staff’s pay. What do they do with the rest 20 per cent?”

Implication of trend for patients

Continuing, Dr Ogunbekun expressed fear that the average patients’ inability to access healthcare might mount bigger crisis for the country in the days ahead.

“The situation is sure to promote quackery. This will further lead to complications and damage to patients’ vital organs. Bigger diseases will then follow.

“We are likely going to see people with hypertension being unable to eat well let alone buy their drugs. We might likely see people dying of hypertension-related diseases, stroke and diabetes. People with asthma too will be at risk.

“I see people getting sicker and sicker; more people will go from acute to chronic conditions and eventually die. The number of deaths will then increase.”

How hospitals are coping

Dr Ogunbekun also revealed that most hospitals as a way of coping with the challenges are adopting a number of critical measures.

He said: “What we are doing now is to invent coping skills.

“Some hospitals I know are having regular engagements with their staff. They know what we generate. And we don’t want to sack anyone.

“In our situation, we cannot tell our staff to stay at home or come to work twice a week. That’s not possible. Medical practice doesn’t work that way. People must be on duty 24 hours of the day. We must have the barest minimum number of staff to operate.”

Talking about how they manage their patients, he said: “We now negotiate our bills with our patients. We have to; we now give discounts.

“Imagine how patients used to complain in the past. You can imagine how they are complaining now that the economy is looking worse.

“So, what we do now is to tell our patients the cost of our drugs. Then we play with our consultation fees, bed fees, and professional fees; we have to cut back on all that, but not on the cost of our drugs, because we must buy those drugs back, same for laboratory materials.

“If we don’t do what we are doing, we will be scaring away our patients; if they don’t come to us, how do we sustain our services?”

Optimism things will change

However, Dr Ogunbekun is upbeat that things will turn around. He believes the economy will improve if the government stays committed to improving the situation on ground.

“This economy has to change. Things have to improve. I believe with what the government is doing now, in a matter of time things will change.

“If the government will channel the resources it said it has saved so far to more productive ventures, things will turn out differently. I believe that.”

Advice to the government

Izuka believes that the government needs to kick in now to stave off the fledging drug crisis.

“It is my honest wish that the government should act fast in the best possible way to curb this current situation.

“The way it is trending, I’m sure that not long from now, many of the common drugs in the market will be very difficult to purchase.

“One of the things that ought be done now by the government is to exempt drugs from the kind of duties placed on medicament and medical devices. That way, they can be made more affordable.

“It is unfortunate that because of our kind of system, those who have the privilege of being in charge seem to know it all. Whatever they chose to do is what they go ahead to do. They don’t listen to anybody.

“The big men up there will always jet out to get the best attention overseas and upon their return, turn around to ask the rest of us to tighten our belts.

 “But the fact remains that drugs are not items you allow to go to the level where the ordinary man will not be able afford them.

 “So, one of the best things to do now ought to be to ensure that the suggested palliatives by the government be extended to the health sector to help it to survive.

“There must be subsidy extension to the drugs sector otherwise there will be bigger crisis,” he said.

BREAKING NEWS: Nigerians have now been approved to earn US Dollars; let’s show you the process and methods to earn $5000-$10,000 monthly. Click here to see the possibilities.

Reports recommended improving budgeting and forecasting, reforming procurement and payment processes, enhancing coordination among stakeholders, and shared responsibility by government and industry to secure supplies.

Conclusion: Medication shortages increased in 2021–2024, affected many essential drugs, and were driven by manufacturing, supply-chain, and financing failures; health systems relied on alternative products, financial measures, and procurement reforms to cope.


Supply problems for medicines increased sharply after 2020, with the Nuffield Trust reporting that supply problems doubled since 2020.

In the United States there were more than 250 medications on the national prescription drug shortage list, and 2023 was described as the worst year for shortages in about a decade.

Most shortages involve generic medicines and FDA data show roughly 90 percent of U.S. prescriptions are for generics while NIH reporting indicated that most drugs involved in shortages are generic options.

Specific products named in reports include Adderall, lidocaine, amoxicillin and some chemotherapy drugs, and commentators also highlighted frequent shortages of epilepsy and ADHD medications.

Ireland experienced a prescription paracetamol supply issue during a surge of COVID‑19 and winter flu, with some suppliers indicating resupply would occur in January 2023.

Reported root causes included shortages of raw materials, manufacturing difficulties, industry consolidation, production quality problems, production delays, and product discontinuations.

Shortages contributed to higher prices, with a reported 16.6 percent increase in the price of drugs involved in shortages and instances where alternative drugs were priced at least three times higher.

Patients and families coped by skipping doses, splitting pills, not filling prescriptions, driving between pharmacies to locate medicines, or purchasing drugs outside the country when domestic costs were unaffordable.

Hospitals and clinics faced operational and financial strain from shortages and high drug costs, including accumulating debts to suppliers, greater pressure on budgets, and staff retention challenges.

A detailed review of Jordanian public hospitals identified centralized procurement problems, inaccurate hospital budgeting, delayed payments that resulted in large outstanding debts to drug companies, slow auditing procedures, and weak coordination as drivers of shortages.

Health authorities and professional bodies advised using therapeutic alternatives such as different strengths, brands or generics and recommended consultation with pharmacists or prescribers when the originally prescribed product is unavailable.

Hospitals in some settings reported coping measures such as negotiating patient bills, offering discounts, adjusting consultation and bed fees, and engaging staff to sustain services amid drug cost and supply pressures.

In the United States and elsewhere, patients and providers also relied on coupons, discount platforms, patient assistance programs, 340B and sliding‑scale clinics, and alternative online pharmacy models to obtain or afford medicines.

Practical steps repeatedly recommended in reports were to check national drug‑shortage lists, contact pharmacists or practice pharmacists about current availability and therapeutic alternatives, refill before supplies run out, and use verified discount or assistance programs when needed.

Between 2021 and 2024 medication shortages were widespread and multifactorial, affecting many essential generic drugs; they were driven by manufacturing and raw‑material problems, industry consolidation, procurement and financing failures, and inflation, and systems coped by switching to alternatives, using assistance programs, and negotiating locally — caregivers should monitor shortage lists, consult pharmacists and prescribers about alternatives, and arrange early refills or assistance where possible.

Supply problems for medicines increased sharply after 2020, with the Nuffield Trust reporting that supply problems doubled since 2020.

Title:

Content: Is a prostate issue to blame for my sexual problems after I started online dating aged 76 following divorce? Ask DR ELLIE CANNON

Q: I’m a healthy 76-year-old and I just started online dating after my divorce. However, during sex I struggle to maintain an erection. Also when I climax, I experience a pleasurable feeling but produce nothing. Should I be worried about my prostate?

Dr Ellie replies: Men often experience sexual problems later in life because of an enlarged prostate or its treatment. The prostate is a small gland at the base of the bladder around the tube that carries the urine out. It is often described as being the size of a walnut, but as men age, it can become much larger than this.

Regular exercise, quitting smoking and cutting down on alcohol have all been shown to help combat erectile dysfunction

Of course, men can also get prostate cancer. An enlarged prostate will make it more difficult to urinate, due to the proximity of the prostate to the bladder, and trigger sexual problems.

These issues are typically erectile dysfunction and difficulty ejaculating. There are treatments which can combat an enlarged prostate, but it’s important to know that these too can lead to sexual problems.

READ MORE: DR ELLIE CANNON: Are the drugs I'm taking to blame for my hip pain?

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One commonly used medication for prostate problems is called finasteride, a daily tablet which can make it easier to pee.

However, more than one in 100 men who take it will have problems getting an erection and or problems ejaculating.

Men who don’t respond to medication are often offered a transurethral resection of the prostate – known as a TURP – which involves cutting away sections of the prostate.

It is thought that as many as three-quarters of men who receive a TURP will have difficulty ejaculating due to damage to the nerves and muscles in the prostate region.

Likewise, surgery to remove the prostate often leads to dry orgasms – where nothing comes out – as the gland is involved in the production of semen.

There are things you can do yourself to reduce the severity of your symptoms.

Regular exercise, quitting smoking and cutting down on alcohol have all been shown to help combat erectile dysfunction.

If the problem continues – or gets worse – then you should talk to your GP about treatment.

Q: I’m a woman in my late 70s. In 2018 I was prescribed alendronic acid after I had a fall and fractured my wrist. I have heard that you should take a break from this medication after five years but my GP says I should stay on it. I also requested another bone density scan but she said I didn’t need one. Is this correct?

Dr Ellie replies: Alendronic acid is the medication we most commonly use for the bone-thinning condition osteoporosis, and it is usually safe to take long-term.

It is taken as a weekly tablet or drink and reduces the risk of further breaks. Our bones are constantly being broken down and rebuilt by specially adapted cells within them. Osteoporosis occurs when there is too much bone breakdown happening which causes them to weaken. Alendronic acid slows down this process. Usually after five years on the treatment you would have a review of your medication to decide if you still require it. This would often involve a bone density scan, also known as a Dexa scan. A patient may stay on the medication for another five years or take a ‘treatment holiday’ and come off it for a few years.

Alendronic acid does have some common side-effects including constipation, dizziness and headaches

Alendronic acid does have some common side-effects including constipation, dizziness and headaches.

If the treatment is causing too many problems, or is failing to keep the osteoporosis under control, patients might be offered a new drug. However, it is hard to make this decision without a further Dexa scan.

The Royal Osteoporosis Society offers excellent support – you can speak with one of their specialist nurses on 0808 800 0035. After this, it would be worth requesting a conversation with the GP to establish why your medication is being continued.

Q: My GP advised I take statins, but ten days after I began the pills I developed serious pins and needles in my feet and hands. I immediately stopped taking the drug, but two months later, the pins and needles have turned into a painful stabbing sensation all over my body. My feet feel like they are burning.

Despite this, my GP refuses to see me for an appointment because he says it is a matter for a pharmacist. What should I do?

Dr Ellie replies: This is not the standard of care someone should be receiving from an NHS GP. Anyone with new symptoms or potential medication side-effects should be offered an appointment.

It might be worth looking into registering at a new practice, so you can get easier access to a doctor. Pins and needles are an uncommon side-effect of statins. The fact the sensation has continued after you stopped taking the pills could suggest it is unrelated. A feeling of electric shocks or burning, particularly in the feet, can be a condition called peripheral neuropathy where the nerves are not working properly. Peripheral neuropathy is often triggered by a vitamin B12 deficiency, and can be reversed. This is why it is crucial that you see a doctor.

If it is the statins, a GP can recommend other ways of treating cholesterol such as diet and lifestyle changes, or other medicines.

DRUG SHORTAGES PUT PATIENTS AT RISK

Medicine shortages are worse than ever, and are now affecting people’s health, according to a new report.

Supply problems have doubled since 2020, the Nuffield Trust think-tank found. GPs and pharmacists deal with this daily.

I do not recall shortages like this even being an issue

ten years ago.

Medicines for epilepsy are often in short supply. Without these, seizures are more likely and can be catastrophic. And I know parents who drive to many pharmacies to find ADHD drugs for their children.

If you have a practice pharmacist at your GP surgery, try to ask them if there are shortages of your prescription drugs, and whether alternatives can be had.

Doctors tend not to know what is and isn’t available.

Are you struggling to get hold of vital medication? Write and let me know.

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Back pain sufferers are being fobbed off

Latest figures suggest a staggering 2.8 million Britons are ‘economically inactive’ due to ill health.

That’s double the number of ten years ago — and includes a rise of almost three-quarters of a million since the pandemic. This is probably because getting treatment for even serious problems is so difficult now.

Mental illness and respiratory diseases top the list of reasons for going long-term sick. The other most common is ‘musculoskeletal problems’, often back trouble. But back pain can be resolved quickly with advice, exercise and a physiotherapy assessment.

It frustrates me that, even if I refer my patients for the latter, it’s just not available — they’re fobbed off with phone appointments and leaflets. Have you struggled to get help with your back pain? Write and let me know.

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk

Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.

In the United States there were more than 250 medications on the national prescription drug shortage list, and 2023 was described as the worst year for shortages in about a decade.

Title:

Content: Prescription drug shortages lead to higher prices

Reporter: Andryanna Sheppard
Published: Updated:
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Millions of people in the United States depend on prescription drugs to manage pain, treat medical conditions, and even to help them stay alive. However, the country’s drug shortage is making it hard for some people to get the medication they need or pay for the drugs that are available.

Federal Drug Administration data shows 90 percent of prescriptions in the US are for generic drugs. According to the National Institutes of Health, most prescription drugs involved in shortages are generic options.

There are currently more than 250 medications on the nation’s prescription drug shortage list, according to the American Society of Health-System Pharmacists. The organization says 2023 marked the worst year for shortages in about a decade.

Jessica Kahn’s two sons were diagnosed with ADD.

“I would say tricky, tricky to navigate,” Kahn described.

For the past year, Kahn said getting their medication has been frustrating.

“I have my list of all the pharmacies. I’ve even driven all the way up north to Walgreens or a CVS, some random place to go pick up a kids’ prescription,” Kahn added.

According to the FDA, prescription drug shortages are often linked to manufacturing and quality problems, delays, and discontinuations. Two drugs used in chemotherapy, Adderall, lidocaine, and amoxicillin are just a couple of the prescription medications on the shortage list.

When drug supplies are low, prices tend to increase. According to the US Department of Health and Human Services, there is a 16.6 percent increase in the price of drugs involved in a shortage. And in some cases, alternative drugs were priced at least three times higher.

“You got to be very conscientious that it might not be available and that it is not an option,” Kahn advised. “No matter how many places you call, it’s not there.”

Beating the prescription drug shortage

Health experts offer these tips:

  • Check the national drug shortage list for your medication and possible alternatives.
  • Don’t wait until your prescription is almost gone to refill it.
  • Check other pharmacies for availability and if you can’t find the generic version, look for coupons or programs that offer payment help. Some patients have reported that they receive additional help to reduce some prescription costs from $100 to $10, it’s not allowed if you are already on Medicare.
  • Websites and apps like GoodRX, RX Saver and WellRX can help you find the cheapest place that has your medication and coupons for it.

Contributors to this news report include: Lindsay Dailey, Producer; Bob Walko, Editor

Copyright ©2024 Fort Myers Broadcasting. All rights reserved.

This material may not be published, broadcast, rewritten, or redistributed without prior written consent.

Most shortages involve generic medicines and FDA data show roughly 90 percent of U.S. prescriptions are for generics while NIH reporting indicated that most drugs involved in shortages are generic options.

Specific products named in reports include Adderall, lidocaine, amoxicillin and some chemotherapy drugs, and commentators also highlighted frequent shortages of epilepsy and ADHD medications.

Ireland experienced a prescription paracetamol supply issue during a surge of COVID‑19 and winter flu, with some suppliers indicating resupply would occur in January 2023.

Title:

Content: Ireland has been suffering a paracetamol shortage as cases of Covid-19 and the winter flu in the country soared over the festive and new year period.

The revelation was made by Health Minister Stephen Donnelly after his department received notification of a supply issue from the Health Products Regulatory Authority.

It is understood the shortage impacted some prescription paracetamol products.

Read More:Irish people complain of ‘worst ever’ winter bug sweeping country that feels like Covid but isn’t

Two suppliers affected have stated that resupply will be sometime in January 2023.

However, there are other prescription paracetamol suppliers with some stock available on the shelves.

Paracetamol is one of the medicines used most often in Ireland and especially for the flu, aches and pain.

But Mr Donnelly pointed out that there are multiple forms of the drug with different strengths and brands available from various sources.

He said: "In the event that there are some supply issues for individual medicines, alternative options such as alternative strengths and brands, generic medicines will usually be available to ensure continuity of treatment.

"In some cases where the medicine initially prescribed for the patient is unavailable, patients may be switched to a suitable therapeutic alternative following appropriate consultation with a healthcare professional."

The Health Minister said medicine shortages have been increasingly prevalent worldwide over the past decade. The causes of such shortages are multifactorial including shortage of raw materials, manufacturing difficulties and industry consolidations.

He stated: "Medicine shortages can originate at any point in the supply chain. They can involve and impact many stakeholders in different ways as the supply models and clinical use of therapies can vary across national health systems.

"Management of medicines shortages necessitates a multi-faceted, multi stakeholder response to ensure patient safety , continuity of care and protection of public health.

"Patients or their carers who have any concerns in relation to temporary alternative products provided because of medical shortages are advised to speak with their pharmacist or other healthcare [professionals] involved in their care."

Mr Donnelly was responding to a number of written Dail questions on the shortage of medicines.

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Reported root causes included shortages of raw materials, manufacturing difficulties, industry consolidation, production quality problems, production delays, and product discontinuations.

Shortages contributed to higher prices, with a reported 16.6 percent increase in the price of drugs involved in shortages and instances where alternative drugs were priced at least three times higher.

Patients and families coped by skipping doses, splitting pills, not filling prescriptions, driving between pharmacies to locate medicines, or purchasing drugs outside the country when domestic costs were unaffordable.

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Millions of Americans Can't Afford Their Prescription Drugs. Now What?

As the cost of medication soars, patients are turning to online coupons and financial assistance programs.

When 27-year-old Savanna Braun changed jobs last December, she had more to worry about than meeting co-workers and adapting to an unfamiliar schedule. A new job meant different insurance, and that meant jumping through hoops to get approval for her lifesaving prescription drugs.

With insurance coverage, which costs her around $5,100 a year, she pays an extra $960 annually for medications to treat her severe asthma, psoriatic arthritis and depression. Those pharmacy benefits soften the bill -- without insurance, she'd be looking at a staggering $200,000 a year.

As basic expenses increase, soaring prescription drug prices are eating up an even larger portion of household income. Over just the last year, prescription drug prices rose at an average rate of 31.6%, with some increasing up to 500%, according to a recent Department of Health and Human Services government report. Americans, who pay the highest prices in the world for prescription drugs -- two to three times more than people in other countries -- are finding any way possible to get around the entangled pharmaceutical industry.

Exorbitant prescription drug costs disproportionately hurt lower-income households, particularly the uninsured and underinsured populations (9% and 23% of US adults, respectively). Black, Latino and Native American people are less likely to have health insurance and more likely to face cost-related barriers to treatment, according to the Commonwealth Fund, a nonprofit focused on health policy reform. Without insurance, patients are forced to sacrifice their medications for more immediate needs, such as housing or food. Those who are reliant on prescription drugs to manage their chronic conditions can often accumulate medical debt

Almost a third of the US adult population, including those with insurance, can't take their prescriptions because they can't afford it, according to Frederick Isasi, executive director of the health advocacy group Families USA. The crisis has damaging consequences: Nearly three in 10 adults end up skipping doses, cutting pills in half or not filling their prescription, resulting in long-term health complications. Others get desperate -- as many as 8% of American households have purchased medications outside the US to get a lower price.

But there are far less risky workarounds. Some patients score significant cost savings by opting for generic medications, requesting alternative medication from their providers or even switching pharmacies. Others who are financially vulnerable turn to advocacy organizations, sliding-scale health centers or patient assistance plans. And many turn to third-party sites like GoodRx, NeedyMeds.org or, more recently, Mark Cuban's Cost Plus Drug Company to cost-compare medication prices, get coupons and save at the register.

When drug costs stand in the way of patient health

Braun had her first run-in with high-cost medicine when she was 3 years old. After she had a life-threatening asthma attack, her doctors said the best treatment was an adult-only prescription. The insurance company didn't want to cover a drug that wasn't approved for her age group by the Food and Drug Administration, though it eventually gave in.

Controlling her asthma soon became a whirlwind of nebulizers, inhalers and steroids, all of which cut into her family's budget. Every time her father changed jobs, she had to wait months until his benefits kicked in, and the bureaucratic obstacles to get her meds began again.

With the 2010 enactment of the Affordable Care Act, Braun's family could no longer be denied insurance coverage or charged more for her preexisting condition. But a few years later, after Braun was diagnosed with psoriatic arthritis, she struggled with trying to find the right medication, and most of them took months for insurance to authorize. Her list of tested drugs read like a pharmaceutical representative's brochure: Methotrexate, Humera, Solara, Remicade and Xeljanz. When her asthma worsened, her pulmonologist told her to take Xolair, but insurance initially denied her, saying she needed to have less lung function to warrant its use.

When Braun turned 26, she got kicked off her parents' insurance plan and lost coverage for all her medications. For months, she was stuck relying on her doctor's samples to keep her symptoms at bay. Not having access to her specialized drugs and treatment set her back. "I was losing lung function rapidly," Braun said, noting that she now has permanent lung damage from not being able to control her asthma. Braun was constantly worried about ending up on a ventilator in the hospital without insurance coverage. "I was pretty scared for my life," she said.

When insurance obstacles stand in the way of patient health

Julie Whitehead, 52, who has bipolar disorder, tackles similar insurance hurdles, which take a huge toll on her mental health. In 2015, Whitehead's doctor prescribed a new mood stabilizer, Abilify, but her insurance company balked. At the time, Abilify didn't have a generic option, so it would cost her $1,000 a month out of pocket.

Because Whitehead couldn't afford the hefty price tag, she was prescribed a different medication, Geodon, for her bipolar disorder. But after six months taking it, she became suicidal. "I had been in a good place for five years, and then I was hospitalized," Whitehead said.

In 2020, Whitehead's doctor wanted to change her medication to Latuda, which required prior authorization. Prior authorization requires a lot of time-consuming paperwork, and if doctors agree to do it, they often charge for it. Whitehead had to wait three months for a green light, and in the meantime she struggled to pay out of pocket for Latuda, which cost more than her monthly Social Security disability check. Luckily, Whitehead's husband had enough income to help her cover the cost. But the process made her angry -- she was trying to "forestall a medical catastrophe," and wasn't allowed to because of an insurance denial.

Today, Whitehead pays around $200 a month for her 11 prescriptions under her husband's insurance plan. "It's one thing to be without insurance and have to depend on Medicaid and Medicare Part D," she said. "But to pay a king's ransom for insurance and for it to still not cover what you need, that's in some ways worse."

A David versus Goliath fight

As many as 28% of adults end up having to take a prescription that isn't covered by their health insurance, and 13% have had a prescription medication dropped by their health insurance plan, according to a survey conducted by GoodRx Health. In 2016, Americans spent some $66 billion total for out-of-pocket retail prescription drugs.

Additionally, many pharmaceutical companies place the drugs that treat chronic diseases such as diabetes, asthma, HIV/AIDS and hepatitis B and C in higher specialty tiers with greater out-of-pocket prices. People of color are disproportionately impacted by these types of serious illnesses and health conditions, making such drug-tier policies openly discriminatory, according to the National Academy for Health Policy.

Disputing a denial from an insurance company for an important medication takes time and effort -- it also requires a certain amount of financial literacy and tools, which aren't generally accessible to historically disadvantaged groups. Some patients never try negotiating with or appealing to their providers or insurance companies on costs.

Vulnerable consumers going up against the pharmaceutical behemoth is a David and Goliath fight, according to Isasi. From 2000 to 2018, 35 pharmaceutical companies reported a combined $11.5 trillion in revenue. With so much in profits at stake, the pharmaceutical industry focuses its lobbying efforts on keeping drug prices high and reducing its competition by gaining monopoly power through patents.

While pharmaceutical companies claim that high drug prices are needed to cover research and development, a recent study conducted by an international team of researchers showed no association between pricing policies and R&D investments. Drug companies set the price, regardless of how much it costs to make the medication. "It's usually a half a penny, or one cent, to actually produce that drug," Isasi said. "Why is it that a drug company can charge whatever they can get away with?"

Alternative paths to obtaining affordable medicine

The debate over prescription drug prices has for decades taken center stage in congressional hearings and among lawmakers. The recently passed Inflation Reduction Act has an extremely limited provision allowing Medicare to annually negotiate prices with pharmaceutical companies on 10 pricey medications, starting in 2026. It also caps out-of-pocket prescription drug costs at $2,000 for those with Medicare Part D drug plans, but not until 2025.

A multitude of organizations focus exclusively on pushing common-sense reforms and achieving policy changes to lower the price of prescription drugs. But until there's a monumental overhaul to the global pharmaceutical industry, there are a few government-based solutions that help medically underserved populations obtain lifesaving medication. For example, Federally Qualified Health Centers offer a sliding scale for certain drugs, and the federal 340B program allows certain hospitals and clinics to buy discounted outpatient prescription drugs for low-income and uninsured patients.

The next step, according to Isasi, is for patients to check if they qualify for Medicaid, through the website. Though eligibility income levels are very low, the expansion of Medicaid in 39 states has helped many financially vulnerable households cover the cost of prescription drugs. And Medicare patients age 65 or older can try applying for the Extra Help federal program to get their medicine at a very reduced, income-adjusted rate.

Patients can also try looking for coupons, rebates or price comparisons online. GoodRx offers discount coupons for all FDA-approved medications, both brand name and generic, regardless of insurance status. If there isn't a GoodRx coupon available, the site will offer a coupon from the manufacturer to bring down the price, or show options for similar medications that may be more affordable, according to co-founder Doug Hirsch. Patients can present a GoodRx coupon to the pharmacy immediately, and the price is better than an insurance copay more than half the time, said Hirsch.

The Cost Plus Drug Company, launched by the billionaire Mark Cuban, is a new online pharmacy that slashes prices on generic prescription drugs. A recent study in the Annals of Internal Medicine, co-authored by Harvard Medical School fellow Dr. Hussain Lalani, found that Medicare could've saved $3.6 billion in 2020 if it purchased 77 prescription medications through Mark Cuban's company. Uninsured and underinsured patients get the biggest benefit from using Cost Plus, Lalani said. But patients should look elsewhere if they need a brand name or clinician-administered drug, or if they need their generic medication immediately, since generics from Cost Plus come through the mail.

Read more: How to Get Cheaper Prescription Medicine With Cost Plus Drugs

Then there's NeedyMeds.org, an organization started in 1997 by Dr. Richard J. Sagal, which assembles roughly 40,000 patient-assistance programs for people who can't afford medication and health care costs. It's a free, nonaffiliated information outlet, and visitors to the site are anonymous. Sagall said it receives up to 15,000 daily users looking for low-cost clinics, prescription savings, rebate programs and more. The organization also gets up to 6,000 calls a month to its toll-free hotline from patients seeking resources.

Sagall, a former family physician, said he's helping more people through the website than he ever did in private practice. "Our ultimate goal is to go out of business for lack of need," said Sagall. "I don't see that happening in the near future."

Hospitals and clinics faced operational and financial strain from shortages and high drug costs, including accumulating debts to suppliers, greater pressure on budgets, and staff retention challenges.

Title:

Content: …As drugs prices skyrocket, many now out of reach

Hospitals, patients, pharmacists groan, fight for survival

By Cosmas Omegoh

Are crises looming in the healthcare sector at the moment? The answer is in the affirmative. And there are chances that such crises are in the multiple, as indications suggest. That is the reality before everyone, although many are yet to realise it until they fall sick.

Now, take a walk down the road; stroll into that next-door pharmacy shop. Then ask the pharmacy attendants about the price of the drug you purchased the last time, about three months ago. The price must have changed unarguably considerably. Its current price tag is sure to send you screaming in shock.

And then walk into a hospital in that neigbourhood and ask to be treated for that minor ailment. You will be dazed by the bill you will be handed down  afterwards.

The reality right now is that most people who have one thing or the other to do with the healthcare sector is groaning and lamenting. Every patient currently weaving in and out of hospital at the moment in search of wellness is complaining.

Just as it is in many other sectors of the economy, so it is in the drug industry where things are particularly steadily falling apart.

Now, here is what a recent Sunday Sun investigation revealed: those in the drug supply chain are bitterly complaining that their customers now can hardly afford the prices of drugs.

Health workers on their part are worried that only a handful of their patients are becoming barely able to pay for their hospital bills. The former are feeling embittered, fearing that their facilities might collapse with time as a result of lack of patronage, revenue and job losses.

Now, experts fear that patients might be becoming sicker. Because of sharp increases in the cost of drugs and hospital bills, a lot more people might either be resorting to self medication when they are ill, or falling back to the traditional way of treating themselves.

However, a healthcare expert, Dr Abayomi Ogunbekun, believes that the situation will ease off with time. But for now, his fears are definite: that in the interim, the current regime might result to “high morbidity and high mortality.”

He said that if the situation persists, many more people might begin to fall sick more easily and then die.

Analysts insisted that the current hardship in the country and people’s inability to meet up with their needs, are coming on the margin of sweeping policies recently introduced by the current central administration.

Following, for instance, the “subsidy is gone,” declaration by President Bola Ahmed Tinubu in his inauguration speech, petrol prices is now hovering between N500 and N700 depending on one’s location, up from N185. Consequently, a considerable number of people are now spending far more of their income buying fuel and paying transport fares. The latter had soared highly on every route lately. Therefore, transportation is now taking out a large chunk of people’s earnings.

Besides, the recent merger of the official and parallel foreign exchange windows is seeing the Naira exchanging well above N800 with the dollar – a move experts suggest has forced a devaluation of the local currency. That is already driving prices of goods and services to the sky.

Then, there is also the hike in electricity tariff. Consumers are now forced to pay higher amounts for the electricity them consume.

Those who know insist the government’s recent policies are pushing up price and forcing the ordinary persons into multi-dimensional poverty. That most people now care much more about what to eat than anything else, with concern about their health taking the backburner – because they can no longer afford the high cost of drugs and hospital bills as much as they used to in the recent past.

Drug prices on the rise

While reflecting on the ongoing trend, a community pharmacist, Mr Damian Izuka, described the current soar-away prices of drugs in the Nigerian market as worrisome.

“We are in a moment of inflation. The price of everything now is going up; since the price of every commodity is rising, those of drugs will not be an exception. That is pure elementary economics,” he explained.

While maintaining that his colleagues in the industry are not to be blamed, he said: “The increases in the prices of drugs are not the making of any pharmacist or drugs supplier. Not at all! It is brought about by the reality of the economic situation we now face.

“Everyone knows that the cost of the dollar to the naria is up there in the clouds. And now, it is inching towards the N900 mark, with clear indication for everyone to see that towards the end of the year, it will hit N1,000. Everything seems to be heading up to the sky. Therefore, what will happen is that because we are majorly a consuming nation, prices will continue to go up until we realise the need to look inwards and do what other nations who are doing well are doing. Unless we do that, inflation will continue to bite harder.”

Fears over cost of drugs

Izuka who is a Fellow of Pharmaceutical Society of Nigeria (PSN) is unhappy that the country might be headed for the untoward if nothing is done soon to address the rising cost of drugs.

He said: “I have this fear that what we are in now might snowball into a big crisis.

“To be honest with you, drugs are not luxury products. They are products related to wellness.

“You are sick, you are not feeling fine. Then you go for drugs; they kick in to challenge the illness and you are well again.

“Now, when the prices of those drugs go up and become unreachable to the ordinary person, I cannot imagine what will happen next.

“To tell you the truth, I pity the ordinary man in this country. I imagine the fate of the poor who will be needing drugs at such high prices. Everyone needs drugs to get well. If, therefore, they become not affordable, it will be very bitter, very unpleasant.”

Another community-based pharmacist in Lagos, Nike Abioye, also lamented the rising cost of drugs in the market.

She too revealed that some drugs which used to be fairly affordable earlier were no longer so.

“The last time I went to restock our outlet, the prices I was hearing surprised me; when I asked for (a certain antibiotic), I was told its recent retail price had hit N19,000 per pack.

“I wondered who on earth would buy it off the shelf if I purchased it.

“It was better I bought other lesser drugs which the people could afford than to tie such huge amount of money on a product no one would be ready to touch with a long pole.”

Patients lament drug cost

Also lamenting, Mr Tolu Olajire recalled that he was stunned by the high cost of drugs he was asked to purchase after a visit to a General Hospital in Lagos, stating: “We are seeing the worst of times.

“My son was having this illness which we kept treating at home; we kept buying drugs from the local shop in our area, but they couldn’t cure him.

“When we eventually visited the General Hospital, the doctor wrote drugs for him some of which we were to purchase because they didn’t have them all at the hospital   pharmacy.

“I was only able to buy the quantity the money I had could fetch so that he could start taking until I could buy more.”

Olajire said that he only had to take his child to the hospital because he felt that his ailment was attaining the level that could not be managed at home.

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“For me, local concoction (agbo) is the answer. It is either I buy the cooked stuff from the local vendor or I source the leaves and roots by myself, cook and drink.”

Then he asked: “With the high cost of hospital bills and drugs nowadays, how can we cope?”

In like manner, Mrs Agbo, a resident of Isheri-Oshun, Lagos, told our correspondent that her family and many others in her neigbourhood now depend on the services of a retired nurse in their area for treatment.

“She is our own doctor in this area – our saving grace – popular and kind too.

“Many families depend on her for their wellness.

“The hospitals in this area are very expensive. If not her, I wonder how many will be surviving this hard times.”

Drug cost impact on treatment, hospitals

Dr Ogunbekun who works for Hoarse Memorial Methodist Hospital, Yaba, Lagos, recalled that the ongoing drug crisis in the country was hitting the hospitals.

“Indeed, drugs are very, very expensive these days. The cost of things has gone up astronomically.

“But we have continued to cope.”

Dr Abayomi who is the chairman of Christian Health Association of Nigeria (CHAN), Lagos State chapter, admitted that “the true situation now is that the practice of medicine is beginning to encounter hiccups. People no longer have money to pay for their medical bills.

“Right now, our staff are demanding pay rise. Many are running away, going abroad for greener pastures. Those who are still around, if you don’t give them a better package they walk away.

“Indeed, the cost of medical treatment is skyrocketing. Now, many increasingly can’t  afford it. If you charge the way things are, not many will be able to pay except the billionaires in our midst.

“Now, if we insist on charging highly, we will end up scaring away our patients. Yet, we need to stay afloat to be able to pay our staff’s salaries.”

Dr Ogunbekun affirmed that “things are really terrible in Nigerian now. The cost of transportation alone is consuming above 80 per cent of staff’s pay. What do they do with the rest 20 per cent?”

Implication of trend for patients

Continuing, Dr Ogunbekun expressed fear that the average patients’ inability to access healthcare might mount bigger crisis for the country in the days ahead.

“The situation is sure to promote quackery. This will further lead to complications and damage to patients’ vital organs. Bigger diseases will then follow.

“We are likely going to see people with hypertension being unable to eat well let alone buy their drugs. We might likely see people dying of hypertension-related diseases, stroke and diabetes. People with asthma too will be at risk.

“I see people getting sicker and sicker; more people will go from acute to chronic conditions and eventually die. The number of deaths will then increase.”

How hospitals are coping

Dr Ogunbekun also revealed that most hospitals as a way of coping with the challenges are adopting a number of critical measures.

He said: “What we are doing now is to invent coping skills.

“Some hospitals I know are having regular engagements with their staff. They know what we generate. And we don’t want to sack anyone.

“In our situation, we cannot tell our staff to stay at home or come to work twice a week. That’s not possible. Medical practice doesn’t work that way. People must be on duty 24 hours of the day. We must have the barest minimum number of staff to operate.”

Talking about how they manage their patients, he said: “We now negotiate our bills with our patients. We have to; we now give discounts.

“Imagine how patients used to complain in the past. You can imagine how they are complaining now that the economy is looking worse.

“So, what we do now is to tell our patients the cost of our drugs. Then we play with our consultation fees, bed fees, and professional fees; we have to cut back on all that, but not on the cost of our drugs, because we must buy those drugs back, same for laboratory materials.

“If we don’t do what we are doing, we will be scaring away our patients; if they don’t come to us, how do we sustain our services?”

Optimism things will change

However, Dr Ogunbekun is upbeat that things will turn around. He believes the economy will improve if the government stays committed to improving the situation on ground.

“This economy has to change. Things have to improve. I believe with what the government is doing now, in a matter of time things will change.

“If the government will channel the resources it said it has saved so far to more productive ventures, things will turn out differently. I believe that.”

Advice to the government

Izuka believes that the government needs to kick in now to stave off the fledging drug crisis.

“It is my honest wish that the government should act fast in the best possible way to curb this current situation.

“The way it is trending, I’m sure that not long from now, many of the common drugs in the market will be very difficult to purchase.

“One of the things that ought be done now by the government is to exempt drugs from the kind of duties placed on medicament and medical devices. That way, they can be made more affordable.

“It is unfortunate that because of our kind of system, those who have the privilege of being in charge seem to know it all. Whatever they chose to do is what they go ahead to do. They don’t listen to anybody.

“The big men up there will always jet out to get the best attention overseas and upon their return, turn around to ask the rest of us to tighten our belts.

 “But the fact remains that drugs are not items you allow to go to the level where the ordinary man will not be able afford them.

 “So, one of the best things to do now ought to be to ensure that the suggested palliatives by the government be extended to the health sector to help it to survive.

“There must be subsidy extension to the drugs sector otherwise there will be bigger crisis,” he said.

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Title:

Content: Lack of medicines in MOH hospitals and accumulation of indebtedness Repercussions / solutions
3 hours ago
Dr. Naeem Malkawi
The problem of shortage of medicines in Jordanian hospitals requires quick and effective attention and intervention, as providing medicines to patients is one of the foundations of quality health care and one of the most important strategies of the Ministry of Health, however, the shortage of medicines in many hospitals leads to health, economic and social challenges that threaten the quality of health care and patient safety.
The budget of the Ministry of Health of medicines, vaccines, vaccines and medical consumables for this year 2023 was estimated at 103.75 million dinars, where the actual for the past year 2022 was 93.8 million dinars.
The question is, how did the Ministry of Health accumulate such a large indebtedness in the item of medicines to reach 300 million dinars for pharmaceutical companies?
And why last week was the debt of 2019 cleared and deducted estimated at 50% of the debt for that year?
This means that there is still a delay in the payment of dues for companies for the years 2020, 2021 and 2022 in addition to eight months of the current year 2023, and this brings us to a range of reasons and challenges:
1.
The aim of the Ministry of Health was to reduce the bureaucracy of procedures and overcome the complexity of procurement references in hospitals and health directorates in the governorates and not to obtain price and discount preferences, but the results indicate a defect in the management and mechanism of dealing with the strategy of unified and central procurement, despite the margin for hospital administrations to use the power of direct purchase in cases of necessity.
2.
Preparation of sub-budgets for hospitals: Evidence shows that there is a problem in the preparation of sub-budgets for hospitals and the main budget of the Ministry of Health with regard to the item of medicines, which is due to the lack of accurate and sufficient data on the number of patients and hospital needs of medicines, and the lack of accurate forecasting of future needs.
3.
Delays in the review of financial claims and invoices between the Ministry of Health and the hospitals on the one hand and the pharmaceutical companies on the other hand, is one of the most important reasons behind the accumulation of indebtedness, and this negatively affects the liquidity of the pharmaceutical companies and hinders them from providing a sustainable service in adhering to the procedures of supplying medicines according to schedule.
4.
Lack of coordination and communication: There may be a lack of coordination and communication between hospitals, the Ministry of Health and pharmaceutical companies, which complicates the supply and distribution of medicines and increases the chances of delays and the depletion of medicines from hospitals in the absence of an effective policy for stock management and the time required for stock adequacy.
5.
Focusing on the trade names of certain drugs from specific production sources and not adopting the protocol of writing the scientific name for the prescriptions of patients.
6.
One of the reasons that may be major and important at the same time is the funding aspect and the lack of the necessary allocations or use them in other aspects other than medicines to fill a deficit or emergency during the use of budget items due to the scarcity of available liquidity. Medication.
Lack of medication can lead to:
1.
Threat to patient safety: Lack of medication puts sick people at risk, as this can lead to delays in receiving necessary treatment or the unavailability of vital drugs, putting their lives at risk.
2.
Economic Implications: The lack of medicines entails additional economic costs for the health system and patients.
Medical cases may be referred to other medical centers or private hospitals, increasing pressure on other MOH budget items.
3.
Pressure on health care workers: Health care workers are under pressure as a result of dealing with patients affected by drug shortages and repeatedly facing their inquiries and complaints.
4.
Social repercussions:
Increased anxiety and stress: A lack of medication can lead to an increase in anxiety and stress among patients and their families, as they live in uncertainty about the availability of the necessary treatment.
Lack of medication can affect the level of trust in the health system among citizens, who may feel that the system is unable to provide them with adequate health care.
Increased costs and social burdens: Some patients may have to incur additional costs to obtain drugs from other sources outside hospitals, affecting their financial and economic status.
After all this narrative there must be ways to overcome these dilemmas:
1.
Preparation of budgets scientifically and professionally: Hospitals should develop more accurate standards for the preparation of sub-budgets for medicines, through the analysis of previous data, estimation of future needs and other scientific and methodological foundations in the preparation of budgets and commitment to apply them accurately.
2.
Improve coordination and communication between parties: Coordination between the Ministry of Health, hospitals and pharmaceutical companies should be strengthened through the establishment of structured mechanisms for information exchange, review of invoices, and completion of claims, and not delay them.
3.
Implementation of fiscal reforms: The Government and the Ministry of Health should implement fiscal reforms that provide funding to cover this important item and pay dues in a timely manner, reduce bureaucracy in the financial audit process, and proceed with payment procedures within the timetable mechanism agreed in the tender terms.
4.
Achieving social responsibility: The government and pharmaceutical companies should adopt a social responsibility towards patients by providing these drugs and reducing their prices in the market to make them more accessible to patients while relieving part of the pressure and burden on hospitals.
Addressing the problem of drug shortages in government hospitals requires comprehensive cooperation between all concerned parties from government, Ministry of Health, hospitals, drug suppliers and patients.
To provide medicines on a permanent basis and to ensure the provision of high quality health care to the Jordanian patient.

A detailed review of Jordanian public hospitals identified centralized procurement problems, inaccurate hospital budgeting, delayed payments that resulted in large outstanding debts to drug companies, slow auditing procedures, and weak coordination as drivers of shortages.

Health authorities and professional bodies advised using therapeutic alternatives such as different strengths, brands or generics and recommended consultation with pharmacists or prescribers when the originally prescribed product is unavailable.

Hospitals in some settings reported coping measures such as negotiating patient bills, offering discounts, adjusting consultation and bed fees, and engaging staff to sustain services amid drug cost and supply pressures.

In the United States and elsewhere, patients and providers also relied on coupons, discount platforms, patient assistance programs, 340B and sliding‑scale clinics, and alternative online pharmacy models to obtain or afford medicines.

Practical steps repeatedly recommended in reports were to check national drug‑shortage lists, contact pharmacists or practice pharmacists about current availability and therapeutic alternatives, refill before supplies run out, and use verified discount or assistance programs when needed.

Between 2021 and 2024 medication shortages were widespread and multifactorial, affecting many essential generic drugs; they were driven by manufacturing and raw‑material problems, industry consolidation, procurement and financing failures, and inflation, and systems coped by switching to alternatives, using assistance programs, and negotiating locally — caregivers should monitor shortage lists, consult pharmacists and prescribers about alternatives, and arrange early refills or assistance where possible.