The Relationship Between Patients and Drug Shortages

PC: How do drug shortages directly impact patients?

Ax: I think about the patient as on a continuum. At the low end of the spectrum, you have patients who can't get the drug at all, and at the high end of the spectrum, you have patients that can get the drugs and be on therapy. In between those two, you have all sorts of issues. You have issues where there may be drugs in the market, but you can't locate the drugs. So you have patients shopping pharmacies, going to five and 10 different locations to determine whether or not there's a supply or making lots of phone calls. You have patients that maybe can get the remedy, they can get the therapy, but they can't get it in the doses they want, or they can't get in the volume they need, so they start restricting their intake.

They might take an oral medication every other day instead of every day. They may not be able to titrate up into the medication. They may find that there's a gap in their therapy, that they may not be able to get the drug for two weeks, but that it'll eventually come to them. There’re all sorts of scenarios that happen for patients along that continuum, and frankly, I don't see relief in that for some time to come. I mean, there's just a lot of significant issues.

PC: What do you believe is needed in order to mitigate these issues surrounding the drug supply chain?

Ax: I think transparency is critical to this marketplace, and it isn't necessarily that we need new legislation. I suspect that the regulators have enough legislation in place to do what they need to do, but the regulators need to demand information, and they need to demand it from manufacturers, whether they be international manufacturers or domestic manufacturers. They need to understand from the payer community and from PBMs, where the supply chain is breaking down. Right now, we're not well informed about what's happening in the supply chain. Is it a manufacturing issue? Is it a bottleneck in distribution? Is it a bottleneck in the payer world? There’s lots of different factors here, and we just need better transparency in the system.

One of the things I'll add is, and I talked to this in the past, is that UpScript, our company, is able to provide a digital solution to pharma. We bring medications direct to consumer, and the way we do that is by putting a button on a pharmaceutical manufacturer's website. The consumer then clicks on that button and they come to our platform. Because we have a direct relationship with the pharmaceutical manufacturer, we're actually able to create a supply that is going to be available to patients, and that sort of streamlines a lot of these bottlenecks that are in the marketplace, so we can have an active supply always available to us to be able to fill prescriptions. And so, we think digital solutions like Upscript’s are one of the factors helping the marketplace and will continue to help the marketplace. Another factor will be the impact of artificial intelligence (AI). AI will be able to better predict where there are shortages and where there will be blockages in the marketplace.