Managing pharmaceutical shortages: an overview and classification of policy responses in Europe and the USA

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Beck, Matthias
Buckley, Joan
O'Reilly, Seamus
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Sage Publications
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This exploratory article gives a cross-sectional account of how established health-care systems have responded to the novel challenge of drug shortages. In line with previous research, our analysis confirms the existence of strong path dependence in the adoption of policy responses. This path dependence is manifested in a pronounced typology of response patterns where jurisdictional approaches to the management of drug shortages differ along two core dimensions. These are the salience attributed to the problem, and the level to which state organisations engage with the problem. These patterns are mirrored in the conceptual framing and strategic orientation of the respective drug shortage policies, with: Spanish and Irish drug shortage policies focusing on the individual product level and being largely reactive; US policies focusing on the therapeutic level, with a focus on mitigation; and German and Austrian policies seeking to address the active ingredient level, with a proactive focus on shortage prevention. Despite the importance of legacies, we find evidence of innovation and path creation particularly in relation to the US and German approaches, which we explain by the simultaneous occurrence of internal crisis and pressures from local stakeholders.
Drug shortages , Network governance , Path dependence , Policy innovation , Strong state , Weak state
Beck, M., Buckley, J. and O’Reilly, S. (2019) 'Managing pharmaceutical shortages: an overview and classification of policy responses in Europe and the USA', International Review of Administrative Sciences, doi: 10.1177/0020852318815330
© 2019 The Authors. Reprinted by permission of SAGE Publications.