One thing's for sure, the ever-present problem is escalating into a crisis. The Associated Press reported that the number of new drug shortages occurring each year has tripled since 2006. As of November, 251 new drug shortages were reported this year (2014). The majority of the drugs in short supply are potentially life-saving treatments for cancer, infections and cardiovascular disease.
What's the issue here? Big Pharma clearly likes making money, so you'd think they'd be all over production. They're international in scope, so it's not like access to the raw materials is an issue.
So why would people reliant on medication be threatened with a drug-shortage crisis?
Funny you should ask.
Drugs (brand name drugs, in particular) are incredibly expensive. And more people need them. And someone's gotta pay for them.
When it's private individuals, there's an issue of prioritization (don't buy insurance, can't afford drugs when you need them) but also of base income (can't afford rent and groceries, certainly can't afford insurance or drugs when you need them).
With public health plans like Ontario's, though, the cost of healthcare (including drugs) comes out of revenue, which includes taxes. Politics is like sausage, we're told - we don't care what goes in to it so long as it's cheap and available. The same applies to healthcare.
This is where it gets sticky. Governments that aren't good at internal organization (silo-based work culture) are terrible at finding effective efficiencies, so instead efficiency becomes code for "offer less." As in cuts.
It's not difficult to reframe a cut as a social benefit, however, and sometimes it's actually true. There is a massive pill-popping problem in Canada that costs a ton of money; in some cases, its like people leaving their lights on when they're away from home, it's just easier that way. In other cases, there are serious addiction issues that need to be resolved. This is particularly true on mood-changing drugs like Oxycodone or Dexedrine, both of which serve as legitimate treatments for mental health issues.
But this last one is much more complicated than we give it credit for. We're not quite there yet, but we're slowly starting to grasp the social/environmental factors that impact mental health in the way poor physical working conditions can be detrimental to physical health.
It's through recognizing this that Canada came up with the idea of psychologically safe workplace standards. They're voluntary, though, so nobody's taking them seriously - not even the government that enacted them. The PMO is definitely not a psychologically safe working environment.
This means that we can't just divide the "sick" people that need drugs from the "well" people who don't and should be working; in fact, poor work design is making people sick and in addition to leading to an increased drug use, also impacting performance and innovation.
While in some cases you can reduce the addictive reliance to drugs by changing the environment, you can't remove the drugs, keep the environment and then just expect people to "get over it." That's delusional.
But that's what we're doing. Governments are reducing drug access and looking for the ones that are culturally easy to pull back on, like those related to mental health issues, so as to reallocate pressure dollars to treatments for physical illnesses like cancer, diabetes and cardiac concerns.
There's a butterfly effect of consequences here that adds to a host of other multi-impact policy pieces (e.g. less social service, worse health outcomes, more anxiety, more need for relief, more need for service, less productivity, so on and so forth).
But this is all complex theory. We don't do that anymore; we message soundbites and microtarget issue outreach. That is, after all, what the people want, isn't it?
The confluence of all these ripples are pushing our society in one direction that will not deviate until the system itself deviates.
Which, I guess, is true of any emerging crisis.
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