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Illustration: Aïda Amer/Axios

Generic drugs are becoming both more available and cheaper, but that can have steep consequences, including shortages and safety issues.

The big picture: The number of generics being approved keeps hitting new records, they now make up 90% of all prescriptions dispensed, and these generics keep getting cheaper.

At the same time, the number of quality inspections done by the FDA is decreasing, as Bloomberg's Anna Edney has reported in an investigation of the generics industry.

  • The industry has adamantly pushed back on the idea that generics are any less safe than brand-name drugs.

Shortages are also a problem — while the number of new and ongoing drug shortages was lower in 2018 than in the recent past, it's trending up again, per an FDA report.

  • “Generics by and large are very safe and very effective and increasingly at price points so low that it is impacting the sustainability of the industry moving forward," said Chip Davis, president and CEO of the Association for Accessible Medicines, which represents the industry.

Driving the news: A generic pediatric cancer drug has become "increasingly scarce" to the point that doctors are warning they may have to ration doses, the New York Times reported earlier this month. There's no appropriate substitute for it.

  • Over the summer, one of two manufacturers announced it will no longer make the drug. The remaining supplier has recently had manufacturing issues.
  • Shortages tend to impact older, generic injectable drugs the most, the NYT notes, which are difficult to make and have low prices.

What's next: "There are solutions to the safety and shortage problems that don’t necessarily involve paying much more for these products," said Rachel Sachs, a law professor at Washington University.

  • Civica Rx, for example, is a nonprofit manufacturer that was formed partially to address shortages.
  • On the more extreme side of the spectrum, Sen. Elizabeth Warren has proposed having the government manufacture some generics.
  • More resources could be devoted to FDA inspections, addressing the safety issues raised by Bloomberg's reporting.

Go deeper

Updated 43 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Ipsos poll: COVID trick-or-treat — Study: Trump campaign rallies likely led to over 700 COVID-related deaths.
  2. World: Boris Johnson announces month-long lockdown in England — Greece tightens coronavirus restrictions as Europe cases spike — Austria reimposes coronavirus lockdowns amid surge of infections.
  3. Technology: Fully at-home rapid COVID test to move forward.
  4. States: New York rolls out new testing requirements for visitors.

North Carolina police pepper-spray protesters marching to the polls

Officers in North Carolina used pepper spray on protesters and arrested eight people at a get-out-the-vote rally at Alamance County’s courthouse Saturday during the final day of early voting, the City of Graham Police Department confirmed.

Driving the news: The peaceful "I Am Change" march to the polls was organized by Rev. Greg Drumwright, from the Citadel Church in Greensboro, N.C., and included a minute's silence for George Floyd. Melanie Mitchell told the News & Observer her daughters, age 5 and 11, were among those pepper-sprayed by police soon after.

7 hours ago - Health

Boris Johnson announces month-long COVID-19 lockdown in England

Prime Minsiter Boris Johnson. Photo: NurPhoto / Getty Images

A new national lockdown will be imposed in England, Prime Minister Boris Johnson announced Saturday, as the number of COVID-19 cases in the country topped 1 million.

Details: Starting Thursday, people in England must stay at home, and bars and restaurants will close, except for takeout and deliveries. All non-essential retail will also be shuttered. Different households will be banned from mixing indoors. International travel, unless for business purposes, will be banned. The new measures will last through at least December 2.

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