title: The Impact of Shortages on Medication Prices: Implications for Shortage Prevention.
abstract: BACKGROUND
  Medication shortages are frequent and have clinical and financial ramifications; however, their effect on drug prices remains unknown.
  
  
  OBJECTIVE
  To examine price progression of medications affected by a shortage.
  
  
  METHODS
  We collected prices of medications covered under Medicare Part B, reflective of general market prices, and data on clinically relevant shortages for the period 2005-16. We used linear mixed-effects models to examine the price growth of affected medications.
  
  
  RESULTS
  Shortage medications demonstrated a quarterly price growth of -0.5 % (95 % confidence interval [CI] -1.6, 0.6) in the period preceding a shortage, 4.3 % (95 % CI 3.6, 4.5) during a shortage, and 4.1 % (95 % CI 2.6, 5.5) in the post-shortage period. Medications not affected by a shortage had a quarterly price growth of 0.2 % (95 % CI -0.3, 0.6).
  
  
  CONCLUSIONS
  Medication shortages are associated with price increases, and these increases are likely reactive to the low profitability of the affected medications and thus, proactive collaboration between the US Food and Drug Administration and industry can serve to identify low-profit drugs and evaluate measures to ensure continued production.
authors: Infectious Diseases Division, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, POB, 3rd Floor, Suite 328/330, Providence, RI, 02903, USA.
authors: Michail
authors: M
authors: Alevizakos
authors: Infectious Diseases Division, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, POB, 3rd Floor, Suite 328/330, Providence, RI, 02903, USA.
authors: Marios
authors: M
authors: Detsis
authors: Infectious Diseases Division, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, POB, 3rd Floor, Suite 328/330, Providence, RI, 02903, USA.
authors: Christos A
authors: CA
authors: Grigoras
authors: Biostatistics Core, Lifespan Hospital System and Departments of Orthopaedics and Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.
authors: Jason T
authors: JT
authors: Machan
authors: Infectious Diseases Division, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, POB, 3rd Floor, Suite 328/330, Providence, RI, 02903, USA. emylonakis@lifespan.org.
authors: Eleftherios
authors: E
authors: Mylonakis
mesh_terms: D016527:Drug Costs; D004345:Drug Industry / Q000592:standards*; D006801:Humans; D014481:United States; D014486:United States Food and Drug Administration / Q000592:standards*