Understanding Competition in U.S. Prescription Drug Markets: Entry and Supply Chain Dynamics
I have been a practicing anesthesiologist for twenty years and have seen unprecedented medication shortages arise in the last few years. Our hard-working pharmacists put in overtime to search for critical supplies. Pharmacy directors tell us how acquisition costs are going through the roof, including inexpensive generic medications that previously were readily available but now newly expensive in any case. Years ago the idea of the current FDA Drug Shortage Office would have seemed completely unnecessary to clinicians. I started out my career in medicinal chemistry. There is no shortage of talented engineers and administrators that could safely manufacture more of what our patients need. Yet this talent pool is somehow prevented from getting to work and expanding production of what our patients need. The majority of injectable medications that come through our practice are branded on their labels by GPOs like Premier, far more prominently than the actual manufacturer. The middlemen give plenty of signs of being the market makers. One time the market worked, now we see market failure. Why on earth do GPOs & PBMs have an "anti kickback safe harbor?" Surely the FTC can take action to restore markets to the functional status they once were, to the benefit of our patients and everyone's pocketbooks. Our patients need resolution soon for a secure, safe pharmaceutical supply, which we seemed to have early in my career.