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Shortages of cancer drugs and other life-saving medications are reaching their worst point in a decade, forcing physicians to develop workarounds and the Biden administration to mount an all-of-government response.

The shortfalls are surfacing deeply entrenched problems in America’s drug supply chain, particularly around commonly-used generic drugs. A recent House hearing examined a “race to the bottom” in price that chills investment in manufacturing and can leave just one or two companies actively producing a drug in shortage.
“This generic business, particularly for these complex drugs, these complex formulations, is not a healthy business right now,” Scott Gottlieb, former FDA commissioner and a Pfizer board member told CBS News on Sunday.

“There are things the government can do but most of them are going to cost money. We’re going to have to look for ways to provide more reimbursement for these hard-to-manufacture drugs,” he said.

Driving the news: There are more than 300 drugs in shortage, the highest since 2014, per the American Society for Health-System Pharmacists.

The American Cancer Society warned earlier this month about potentially “life-threatening” supply problems of chemotherapy drugs which “don’t have an effective alternative.” “As first-line treatments for a number of cancers, including triple-negative breast cancer, ovarian cancer and leukemia often experienced by pediatric cancer patients, the shortage could lead to delays in treatment that could result in worse outcomes,” CEO Karen Knudsen said in a statement.

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