"In general, the root causes of drug shortages are well-established. Most shortages involve low-cost, off-patent generic drugs, which have profit margins that a

"In general, the root causes of drug shortages are well-established. Most shortages involve low-cost, off-patent generic drugs, which have profit margins that are razor-thin to non-existent. This is driven by middlemen who have, in recent years, pushed down wholesale prices to rock-bottom levels, to the point that the generics industry often loses money on drugs. This disincentivizes pharmaceutical companies from helping to make much-needed generic drugs and creates fragile supply chains. As KFF notes, several generic makers have recently filed for bankruptcy." Definitely, Pharmacy benefit managers are the culprit. You see the same thing in every sector: the middle men, who don't produce, squeezes the real producers.