TB Drug and Skin Testing Solution Shortages

Most TB control programs in the United States have experienced trouble accessing supplies used in the treatment and diagnosis of latent TB infection (LTBI) and TB disease.  Shortages of TB drugs and skin testing solution (PPD) used for TB diagnosis, care, and prevention have been reported over the past decade; however, reports of shortages have increased within the past several years.  Interruptions in supplies of drugs used for treating infectious diseases pose a significant public health threat by delaying or even preventing some types of patient care allowing disease to spread, and contributing to the development of drug resistance. 

Results of Shortages on Patient Care

Results of shortages on patient care include

• Delays in treatment or testing
• Rationing or restriction of drugs
• Using less effective alternative drugs for treatment
• Occurrence of medication errors and adverse events related to using alternative drugs
• Increases in drug costs
• Increases in TB program costs
• Increases in TB program staff time dedicated to drug procurement 

Reasons for Shortages

Shortages occur for many reasons, including

• Problems with manufacturing (most common)
• Delays in manufacturing or shipping
• Shortages of active pharmaceutical ingredients (API) 
• Imbalances in supply and demand 

What is CDC Doing about the Shortages?

CDC is working closely with state and local TB control programs, the U.S. Food and Drug Administration (FDA), and pharmaceutical companies to try to prevent the interruptions to TB supplies.  Actions taken by CDC include

• Consulting with TB programs when shortages are identified
• Sharing information about drug availability with TB programs
• Providing evidence of impact of drug shortages and increasing drug costs
• Collaborating with FDA to reduce impact of drug shortages
• Releasing health alerts to advise TB programs on options for patient care during shortages

Current Status of Shortages

For information about the current availability of TB drugs and skin testing solution, visit the Food and Drug Administration Drug Safety and Availability website.

Or contact your state or local TB control office to find out how the public health authorities in your area are responding to the shortages.