U.S. Senate Committee on Homeland Security and Governmental Affairs – Majority Staff Report, Short Supply – The Health and National Security Risks of Drug Shortages – March 2023: “Shortages of critical medications continue to rise—including drugs used in hospital emergency rooms and to treat cancer, prescription medications, and even common over-the-counter treatments like children’s cold and flu medicine. The number of active drug shortages in the U.S. reached a peak of 295 at the end of 2022. However, drug shortages are not a new problem. They are caused by a number of factors, including economic drivers, insufficient supply chain visibility, and a continued U.S. overreliance on both foreign and geographically concentrated sources for medications and their raw materials. These shortages have cascading effects on patient care, causing delays in treatment, increasing the risk of medication errors, and requiring the use of less effective alternative treatments. Hospitals have also experienced increased costs, medication waste, and limited staffing capacity to address and remedy shortages. U.S. Senator Gary Peters previously identified these concerns and in December 2019, released a report examining drug shortages in the U.S. The report found that critical generic drugs, particularly sterile injectable products regularly used in hospitals, were at an increased risk for shortages, and that nearly 80% of manufacturing facilities that produce active pharmaceutical ingredients (API)—the key ingredients that give a drug its intended effect—are located outside of the U.S. The report concluded that U.S. overreliance on foreign sources for these drugs posed a national security risk and that in the event of a crisis, such overreliance could have devastating impacts on hospitals, health care providers, and patients.