AHA Comments on Energy and Commerce Committee's Drug Shortages Discussion Draft

August 22, 2023

The Honorable Cathy McMorris Rogers
Chair
House Energy and Commerce Committee
United States House of Representatives
2125 Rayburn House Office Building
Washington, DC 20515

Dear Chair McMorris Rogers:

On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, and our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) thanks you for the opportunity to comment on Energy and Commerce Committee Chair Rodgers’ drug shortages discussion draft.

The AHA shares the committee’s concern about ensuring an adequate drug supply. Our member hospitals and health systems rely on drug therapies to care for their patients. In many cases, access to these critical drugs is in peril, jeopardizing patient health. Hospitals and health systems are most concerned about preserving consistent supply of and access to source generics and other generics, which drug manufacturers may believe lack sufficient business incentive to maintain. While the AHA believes shoring up the drug supply chain is of great importance, accomplishing this goal should not come at the cost of patient care. Reducing access to the 340B Drug Pricing Program would directly impact hospitals’ ability to offer a wide range of health care services to some of the nation’s most vulnerable populations. We urge the committee to pursue other alternatives to support drug manufacturers committed to maintaining access to critical and often low-margin medications that would not hamper existing efforts to provide quality care to patients.

These alternatives include opportunities for the discussion draft to further address the root causes of drug shortages, in particular lapses in quality that require production-halting remediation. Currently, the bill’s approach focuses on increasing drug companies’ reimbursement to strengthen the drug supply chain, but it does not require manufacturers to use these additional resources to prevent and mitigate future drug shortages. We are concerned that some of the payment provisions in the current bill may create perverse incentives for companies to keep some products in shortage. Additionally, there is opportunity for the committee to provide the Food and Drug Administration (FDA) with much-needed data regarding the pharmaceutical supply chain, as well as authority to utilize the data appropriately to improve the resiliency of the supply chain for critical generic drug production and ensure adequate supplies in the event of a shortage.

In comments below, we urge the committee to consider including provisions contained in several other pieces of legislation that AHA supports, which we believe would support drug manufacturers and protect the supply chain for essential medications without limiting patient access to care by reducing the 340B Program.