“Under ‘Crooked Joe’ Biden, there was a catastrophic increase in shortages of essential medicines.”

Former president and current Republican presidential candidate Donald Trump, in a July 24 campaign video

In a recent campaign video, former President Donald Trump blasted President Joe Biden for “a catastrophic increase” in drug shortages.

“It’s a multitude,” Trump said within the video, adding that recent drug shortages were up last 12 months by 30%, with “295 energetic drug shortages” by the top of 2022.

The continued availability of lifesaving drugs is a priority on this country. Reports of shortages of medicines on which many Americans rely — from widely used cancer medications like cisplatin to over-the-counter painkillers similar to Kid’s Tylenol — have been widespread in recent times. The shortages have caused treatment delays or forced clinicians to substitute alternatives instead of preferred therapies.

But is Biden responsible, or is Trump’s claim an oversimplification?

We contacted the Trump campaign for answers, but got no reply. So, we poked around on our own. What we found didn’t align with Trump’s claims. By some measures, drug shortages increased more on Trump’s watch than on Biden’s.

Where to put the blame?

Trump’s statistics were within the ballpark. In keeping with a March report by the Senate Committee on Homeland Security and Governmental Affairs, cited within the video’s footnotes, the variety of energetic drug shortages in 2022 did hit 295 at the top of 2022. The count was 246 at the top of 2021, in line with the American Society of Health-System Pharmacists.

But our calculations suggest the report’s math was off. The report stated a rise of “roughly 30%,” however it was closer to twenty%. Likewise, recent drug shortages grew from 114 to 160 in 2022, a 40% increase, not the “nearly 30%” cited in an earlier version of the report, which Trump apparently relied on.

The Senate panel’s report relies on data from the FDA and the society. The pharmacy group works with the University of Utah Health’s Drug Information Service to trace drug shortages.

The society’s shortage information derives from pharmacists’ and patients’ reports of supply issues that affect how pharmacies prepare or dispense drugs, or influence patient care, often locally. The FDA, with its national scope, declares a drug shortage when demand or projected demand exceeds supply, as projected by drug manufacturers. So, the FDA’s shortage tallies are certain to be different from the society’s. As an example, the FDA reported that recent and energetic drug shortages grew from 124 in 2021 to 135 in 2022, a 9% increase.

But Biden is not the only president whose administration has contended with rising drug shortages. And his numbers thus far aren’t the worst.

Energetic drug shortages grew from 195 in 2016 to 264 in 2019 — when Trump was president. That is a 35% increase, in line with the society’s figures. During Biden’s first 3½ years in office, that very same category of shortages increased 12%, from 276 to 309.

Latest drug shortages peaked at 267, in 2011, throughout the Obama administration, the society reported. Some experts credit an executive order that Obama signed that 12 months directing the FDA to broaden its shortage reporting as a turning point. Since that 2011 high, the U.S. recorded the next-largest number of recent drug shortages — 186 — in 2018, when Trump was president.

The purpose is not that Trump managed drug shortages badly then or that Biden is handling them badly now, experts said.

“I do not think you possibly can tie this to any administration or specific person,” said Michael Ganio, senior director of pharmacy practice and quality on the American Society of Health-System Pharmacists.

Many aspects — from natural disasters and manufacturing problems to slim profit margins on generic drugs — can contribute to shortages. Lingering drug shortages from before the pandemic, “compounded with shortages because of covid and poor quality at U.S.-based corporations like Akorn pharmaceuticals, have really contributed to the very large numbers of shortages we’ve got without delay,” said Erin Fox, associate chief pharmacy officer at University of Utah Health.

The complexity of medication supplies

For a long time, the U.S. has suffered periodic drug and medical device shortages. Disruptions at any point within the complex supply chain involving people, production, technologies, and policy decisions can ripple throughout the system, causing scarcities which will last years.

A Health Affairs article published this past January described the present system’s complexity. Greater than 20,000 prescribed drugs and greater than 13,000 facilities worldwide are registered to make drugs or their energetic ingredients. Greater than three-quarters of energetic pharmaceutical ingredients are made outside the US, the authors said.

Experts acknowledge that counting on overseas drug manufacturers can result in quality control and oversight problems, since it’s harder for the FDA to examine plants overseas. For instance, after an FDA inspection last December that found quite a few manufacturing problems, Intas Pharmaceuticals in India voluntarily suspended production and distribution of its products that were destined for the US. The corporate was allowed to distribute some drugs, including critical cancer drugs, which are in brief supply, with strict third-party oversight. Within the video, Trump also zeroed in on this concern. He pledged — with an emphasis on minimizing China’s role within the production of medicines — to return manufacturing of all essential medicines to the US, “where they belong.”

But the US experiences manufacturing problems and weather emergencies, just as all over the place else on the earth does. For instance, Lake Forest, Illinois-based drugmaker Akorn filed for bankruptcy this 12 months and stopped making greater than 70 generic drugs. After a tornado hit its Rocky Mount, North Carolina, plant in July, Pfizer temporarily shuttered the ability. The corporate said Sept. 25 that it had restarted production on the plant.

“Bringing all manufacturing back to the US not only is not feasible, because we haven’t got the raw materials, but that also creates a reliance on a single geographical area,” said Soumi Saha, senior vp of presidency affairs at Premier, a big group-purchasing organization for hospitals and other health providers. “What you would like is global diversification.”

Marta Wosińska, a health care economist on the Brookings Schaeffer Initiative on Health Policy, agreed with Saha — domestic manufacturing is not a panacea. “Domestic production is not any guarantee of getting a stable supply chain,” she said. “Most shortages are brought on by quality problems in each the US and overseas.”

Trump also criticized Biden for “shamefully” not following through on an executive order Trump signed that directed federal agencies to discover ways to maximise domestic production of essential medicines.

The White House didn’t reply to questions on the status of Trump’s order. But spokesperson Kelly Scully in an announcement pointed to the five executive orders Biden issued since taking office “focused on strengthening the resilience of critical supply chains,” including those for pharmaceuticals.

Our ruling

Trump said there was a “catastrophic increase” in drug shortages under Biden’s watch. Trump was correct that drug shortages have ticked upward. But Trump’s statements blaming Biden for those shortages are inaccurate and lack context.

Not only have significant drug shortages increased during other presidential administrations — including Trump’s — experts generally agree that there are multiple, complex, and interlocking aspects that cause them, meaning nobody person is at fault, not even the president.

We rate this claim False.