The price of a drug given to millions of women in the U.S. every year to help speed up labor or recover from childbirth more than doubled this week, in a sign of deepening market dysfunction that has left some health care providers scrambling to find critical medicines.
Endo International PLC raised the price of a one milliliter single-dose vial of Pitocin at the start of December to $3.60, according to its wholesale acquisition cost, up from $1.68 previously.
Prices for other common hospital drugs including ketamine, an anesthetic, and adrenaline, used to restart hearts and reverse allergic reactions, have also jumped in the past week, according to a company that tracks prices.
The increases are being driven in part by diminishing supplies of many older, widely used medications that reap little if any profit for manufacturers. The number of drugs that are scarce in the U.S. has recently doubled, rising to 110 as of September from 55 in mid-2017, according to the U.S. Food and Drug Administration.
"It's so frustrating to not have the basic supplies that you need and to also be charged more for basic supplies that you don't have enough of," said Erin Fox, the senior director of pharmacy at University of Utah Health, who monitors drug shortages.
Drugmakers say that a broader trend of declining prices has forced them to look for ways to make producing older generic medications economically viable—including by raising prices. Endo spokeswoman Heather Zoumas Lubeski said that the company has been talking with its customers about how to keep prioritizing "low-value products in a capacity-constrained manufacturing environment."
"Discontinuing the product would be irresponsible, and given the supply fluctuations that have occurred, customers need options for supply," she said.
Hospitals and regulators aren't new to wrangling with drug deficits. Drug shortages almost tripled to 178 in 2010 from 61 in 2005. The situation improved in the ensuing years, but injectable drugs used in hospitals have recently been suffering.
"We certainly don't have easy solutions, or we would have fixed this problem a long time ago," FDA Commissioner Scott Gottlieb said in a speech last month. "But it's gone on too long. The risks have mounted. The frustrations have reached a tipping point. Mine as well. We need to commit to fix things for good."
Quality problems at some major manufacturers and cutbacks at others have led to shortages of critical products and created added work for hospital administrators. Even when drugs return to the market, hospitals have to spend time and money changing their practices, said Fox.
"The extraordinary amount of labor that hospitals have to do to manage through the shortages and make sure the patients aren't impacted is unbelievable," she said.