As Healthcare Crises Pile Up, Pharma Struggles to Meet Demand - Updated

Drug supply chain

As the world faces one public health crisis after another, it seems that pharmaceutical companies across the board are having trouble keeping up with the ever-growing need for medicines. BioSpace looks at some of these cases below.

Sore Shortage of Monkeypox Shots

Last week, San Francisco became the first major U.S. city to declare a public health emergency over rising monkeypox cases. The state of New York made a similar move when it officially labeled the virus an imminent threat to public health. California followed soon after.

Both decrees empower local authorities to mobilize more resources against the outbreak, but it has quickly become clear that the problem is a logistical one. Monkeypox vaccines across the country are in critically short supply, leaving the most vulnerable communities in virus hotspots at heightened risk of infection.

With more than 1,500 cases logged thus far, New York City is seeing the country’s largest monkeypox outbreak, followed closely by California, with over 1,100 cases. But both New York and California have yet to receive the complete number of vaccine doses they need to effectively deal with the virus. California, for instance, estimates that it will require some 800,000 doses, but has received only a fraction of it. It declared a state of emergency Monday.

There are currently only two vaccines approved against Monkeypox in the United States: Bavarian Nordic’s Jynneos and Sanofi’s ACAM2000. In mid-July, the federal government announced that it had placed an additional 2.5 million orders for Jynneos, but these will be made broadly available next year.

“Unprecedented Demand” for Wegovy Swamps Novo, Spurs Copycats

On its healthcare information portal novoMEDLINK, Danish multinational Novo Nordisk announced that shortly after it launched Wegovy (semaglutide), it saw an overwhelming demand for the drug, so much so that Wegovy “exceeded the weekly performance of every prior Novo Nordisk product launch.”

Then, one of Novo Nordisk’s contract manufacturing sites encountered production issues, leading to a growing gap in the demand for the drug and the company’s capacity to deliver doses. Novo Nordisk has already announced that “there will be minimal to no supply of the 1-mg dose,” a shortage that began in May and is expected to continue until later this year.

To mitigate these product outages, the company rolled back promotions for Wegovy and asked healthcare providers to avoid initiating patients on the drug. Still, new prescriptions keep coming in and production continues to lag. Rising to fill this gap are semaglutide knock-offs, being pushed online by several health vendors seeking to take advantage of loopholes in regulatory laws and Novo Nordisk’s manufacturing woes.

On Thursday, Novo Nordisk CEO Lars Fruergaard Jorgensen told reporters that the delay wasn't unusual, according to Reuters

"We see that across our own facilities also from time to time," Jorgensen said.

He added, "We are very encouraged about the medium and long-term prospects about that, and we are not worried about short-term delay in supply." 

The company is working to stabilize its Wegovy supply by the latter half of this year but has yet to give a more exact timeline for this.

Supply Woes Cripple Adderall Sales Despite Sky-High Demand

Israeli pharma firm Teva Pharmaceuticals is having trouble meeting the growing demand for Adderall after one of its manufacturing facilities ran into some packaging problems, according to a report by Bloomberg.

The supply issues are affecting both branded and generic Adderall doses, and are expected to last into the fall.

According to the U.S. Food and Drug Administration’s tracker for drug shortages, amphetamine salts, on which Adderall is based, do not seem to be in shortage at the moment. The tracker was last updated at the end of May when the FDA deemed the supply of the drug sufficient. Before that, the regulatory body considered amphetamine salts to be in shortage since September 2019.

Teva is the country’s largest seller of Adderall, both branded and generic. In 2021, the company sold 565 million Adderall pills, more than any other company, according to data from Symphony Health, a healthcare analytics firm cited by Bloomberg.

Pfizer’s Paxlovid Sees Lukewarm Welcome

Last month, the FDA gave state-licensed pharmacists the authority to prescribe Pfizer’s Paxlovid (nirmatrelvir and ritonavir) in COVID-19 patients aged 12 years and up. The drug has seen wide use since then and the company expects it to rake in some $22 billion for the remainder of the year.

Still, the oral antiviral has not been making the big waves it should have, according to a report by Fortune. Citing health analytics firm Airfinity, Fortune points out that Paxlovid’s impressive clinical performance is not enough to drum up excitement for the drug. Since it hit the market, reception has been lukewarm.

In turn, this could lead to a weaker supply chain for Paxlovid down the line, as per Airfinity analysis. Slow uptake of the drug this year would mean fewer repeat purchases next year and in the long run, lower manufacturing quotas. Still, there is much promise for Paxlovid, especially as it accrues regulatory approval in different countries, which could result in a big spike in sales and make Paxlovid the top COVID drug.

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