Price hikes got a bad rap because of a few egregious examples, but they've been responsible for shortages, too. I'm an anesthesiologist. Almost all of our drug

Price hikes got a bad rap because of a few egregious examples, but they've been responsible for shortages, too. I'm an anesthesiologist. Almost all of our drugs are generic. But there have been shortages of one or another for most of the last 15 years. Why? Among other things, the federal government limited price hikes to a percentage per quarter that Medicare and Medicaid would pay (gross oversimplification, but close enough). This sounds like a great idea. But when you can't do a 100% price hike on a drug that sells for 40 cents per ampule, you can't pay overtime and do increased-tempo maintenance to keep a line running almost 24/7. So if one generic manufacturer quits making a drug that only has 2-3 sources, the others simply can't fill in the gap. Sometimes they stop making it because it's no longer profitable, sometimes because other factors (failing to pass an inspection, e.g.) cause a temporary shutdown. But if you can't double the price of a dirt-cheap drug, you often can't double your output (because the drug is cheap - it's the labor, packaging, and regulatory compliance that are expensive, and they scale per dose, not per kg made). This is a very different world from the famous cases you see in newspapers about huge increases in price for medications that have been generic for a long time, but it is there and it really does hit us.