Health Policy and Management
School of Public Health

For years, shortages of both over the counter and prescription drugs have troubled both patients and providers.

It’s an issue that has made its way to halls of Congress, where both chambers are taking steps to address the issue.

In December Inma Hernandez, PharmD., PhD (HPM ’16), a professor in the Division of Clinical Pharmacy at University of California-San Diego’s Skaggs School of Pharmacy, testified to the U.S. Senate Committee on Finance as part of its ongoing investigation into drug shortages around the country.

“Drug shortages are an ongoing public health concern that threatens patients’ access to essential medications. Drug shortages have devastating consequences, leading to delays or omission in the use of life-saving treatments or substitution with less effective drugs, all of which contribute to adverse health effects,” Hernandez told lawmakers.

The biggest issues are in the generic market, which accounted for 84% of the shortages between 2017 and 2023 due to several factors, including the fact that generic drugs are generally not high profit products for makers, so companies often aren’t interested in making them. That means much of the generic drug market leans on international suppliers.

“The recent hearing in the [U.S. House of Representatives] have been focused on the outsourcing of generic drugs. The Senate committee was focused on economic drivers of the drug shortage and how things like reforming Medicare reimbursement models would help” Hernandez says. “The were a lot of technical discussions, about the issue, including who and what influenced drug prices.”

Citing a study published in JAMA, Hernandez told Senators that pharmacy benefit managers (PBMs) can hinder access to lifesaving medication.

“My colleagues and I identified 16 generic drugs that were reimbursed in 2021 at a mark-up of 1000% or higher by at least one of the leading Part D sponsors,” said Hernandez. “As patient co-insurance is based on the point-of-sale reimbursement, this practice likely results in increased out-of-pocket expenses for patients.”

Senator Maria Cantwell (D-WA), a member of the committee, has introduced legislation calling for transparency by PBMs and their pricing models.

Another solution, says Hernandez, is using value-based payments to incentivize large buyers of generics like pharmacies and hospital systems to purchase medicine from manufacturers with more dependable supply chains.

Research conducted by Dr. Hernandez alongside HPM professor and chair, Julie Donohue and HPM associate professor Tina Hershey, published in JAMA in March 2020, regarding drug pricing and shortages was heavily cited by the committee during the hearing, and in the white paper it released in January with policy suggestions that could help solve the problem.

“I am grateful to have worked with Drs. Donohue and Hershey on that research,” says Hernandez. “This issue is tied very closely to the work that has been done and is being done at Pitt.”

To watch Dr. Hernandez's entire testimony, click here. 

- Mike Friend

A leading organization for health services researchers, policymakers and health care practitioners, AcademyHealth’s footprint has grown beyond the research done at the University of Pittsburgh.

Health Services Policy and Research PhD candidates Anna Lewis and Rebecca Bilden, along with faculty advisor Lucy Savitz have chartered a new student chapter of the organization at Pitt.

“Pitt is a leader in the field of health services research, leveraging its connections with the world-class health care delivery via UPMC to advocate for evidence-based practice and policy,” says Lewis, who will serve as chair. “The AcademyHealth student chapter offers a local opportunity to engage in the work of research, dissemination, and advocacy that are the focus of the larger AcademyHealth organization.”

“There is a ton of research being conducted at Pitt with the goal of improving access, quality, and cost of health care. The AcademyHealth student chapter is a way to connect students with diverse perspectives who are interested in this type of research,” adds Bilden.

The group plans to offer seminars with leaders in the field, serve the university community through both service projects and advocacy.
“This student chapter will offer the opportunity for multidisciplinary collaboration, mentoring, and professional development for students from a variety of different programs and departments at Pitt,” says Bilden.

A fledgling organization at the university, Lewis says the first members will be instrumental in laying the groundwork for the local chapter.

“We are excited to engage with students from many different departments and backgrounds who are interested in coming together to support health services research, implementation of the evidence, and advocacy for research-informed policy.”

Membership is open to any student with an interest in advancing health services research. Those who are interested in joining can email Lewis or Bilden for information.

-Mike Friend

The Public Health Dynamics Lab (PHDL) and Dr. Mark Roberts, distingusihed professor of Health Policy and Management, have been awarded a grant from the Centers for Disease Control and Prevention (CDC) to help the response to misinformation around vaccines and increase vaccination acceptance and vaccination rates. 

EDITOR'S NOTE: It's a lot of fun telling stories from the department, but we can't do it alone. If you or someone you know is doing something interesting, send us an email. We like hearing from everyone! (and we mean everyone -- students, faculty, staff and everyone in between)