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Improving the US Supply Chain for Better Patient Outcomes


Robert J. Markelewicz

Robert J. Markelewicz, Jr.
M.D., M.M.Sc
Chief medical officer

For decades, one of the main priorities of the United States healthcare system has been to develop life-saving treatments for one of the nation’s leading causes of suffering and death: cancer. Researchers have spent decades studying the disease to find new therapeutic options and physicians have spent just as long treating the patients affected by it. Over time, advancements in technology have allowed those studying and treating the disease to gain a better understanding of cancer pathogenesis, which therefore has helped to create even more treatment options.

Though there are an abundance of drugs being used and even more being developed, the current process used to bring drugs to patients is failing under economic pressures–wreaking havoc across the healthcare ecosystem. While no standardized process is ever perfect, the US supply chain continues to operate under acute pressure causing an already imperfect drug development process to somehow worsen. Patients and hospitals, as well as biopharmaceutical companies, are feeling the repercussions and are hungry for change.

Impact of the current supply chain

With the supply chain being as large as it is and responsible for the success of the entire healthcare system, one wrinkle in the processes creates a ripple effect, impacting each aspect of the chain. If problems are not addressed, then additional issues begin to arise, forming a continuous cycle of obstacles and leading to a world where patients cannot get the treatment they need–which is where the industry lies today.

Current problems in the supply chain began with manufacturers as they tried to cope with inflation, rising supply costs, and the pressure of keeping their market prices low. To keep doors open while battling these outside factors, many organizations1 across the country cut down their workforce over the course of the year, therefore resulting in production delays. Those who couldn’t afford to pay their employees and produce low-priced drugs, such as Akorn Pharmaceuticals,2 called it quits and made the already low stocked shelves even barer.

While these manufacturers have been reevaluating their business strategies, drug availability has drastically decreased, with a total of 128 drugs3 currently being in a shortage. Of these drugs, 15 of them are cancer specific medications4–some being cisplatin, carboplatin, and methotrexate–which are crucial in cancer treatment. For those who are able to access proper medication, they may end up being left to pay a high price with 112 drugs increasing their pricing above inflation5 just in the month of June.

Addressing the problem

Biotech organizations across the country have been voicing their opinions on this issue for months, but no action has been taken. Recognizing this problem, biotech leaders started taking matters into their own hands with some outsourcing their business to other countries, therefore driving up prices even further. The FDA also acknowledged the dire shortage and allowed a Chinese drug maker to import specific cancer medications6 for a short period of time.

Having heard manufacturers and patients’ cry for help, and realizing the financial impact this has on the United States, the government finally decided to step in. On November 27th, President Biden announced7 a new initiative to strengthen America’s supply chains. These actions announced will not only help manufacturers and businesses boost their finances but will also allow treatment availability to increase and pricing to decrease.

Future of the US drug industry

With the launch of this new initiative, the outlook becomes positive for all parties of the US supply chain. Manufacturers should begin working at their full capacity, drug availability is expected to increase, and the prices of drugs will likely decrease. Though this period of downfall may finally be ending, there is no telling what the future holds–leaving the possibility for the problems we are facing today to arise again. Learning from these events, it is crucial that supply chains be closely monitored to avoid patients being restrained from receiving the necessary and often life-saving treatments.


  1. Armstrong, Annalee; Masson, Gabrielle; Bayer, Max. Fierce Biotech Layoff Tracker 2023: Reneo Reduces Workforce By 70%, Oxurion Cuts Staff Down to 10. Fierce Biotech. December 29, 2023. https://www.fiercebiotech.com/biotech/fierce-biotech-layoff-tracker-2023
  2. Lovelace Jr., Berkeley. How One U.S. Drugmaker Contributed to the Escalating Drug Shortage Crisis. NBC News. July 16, 2023. https://www.nbcnews.com/health/health-news/akorn-us-drugmaker-closure-escalating-drug-shortage-rcna91402
  3. Comer, James. Letter to Robert M. Califf. November 2, 2023. https://oversight.house.gov/wp-content/uploads/2023/11/Letter-to-FDA-re-critical-drug-shortages.pdf
  4. Howard, Jacqueline. US Cancer Centers Still See ‘Widespread’ Shortages of Life-Saving Chemo Drugs, Survey Finds. CNN.October 5, 2023. https://www.cnn.com/2023/10/05/health/cancer-centers-drug-shortage/index.html
  5. Rapfogel, Nicole. Drug Companies Continue To Hike Prices Above Inflation. Cap 20. November 1, 2023. https://www.americanprogress.org/article/drug-companies-continue-to-hike-prices-above-inflation
  6. Dillinger, Katherine. FDA to Allow Imports of Cancer Drug from China Amid Ongoing Shortage. CNN. June 2, 2023. https://www.cnn.com/2023/06/03/health/fda-cisplatin-shortage/index.html
  7. Fact Sheet: President Biden Announces New Actions to Strengthen America’s Supply Chains, Lower Costs for Families, and Secure Key Sectors. White House. November 27, 2023. https://www.whitehouse.gov/briefing-room/statements-releases/2023/11/27/fact-sheet-president-biden-announces-new-actions-to-strengthen-americas-supply-chains-lower-costs-for-families-and-secure-key-sectors/
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