Finding just what the doctor ordered is getting increasingly difficult as more and more prescription drugs become scarce.

From household names like Adderall and Ozempic to cancer treatments, a record 323 drugs were in short supply during the first quarter of 2024, the American Society of Health-System Pharmacists (ASHP) reported recently. The ASHP, which has published the metric since 2001, says the number of hard-to-get drugs has surpassed the previous record high from a decade ago.

It’s hard to overstate the stakes: Not having the right medication on hand is forcing doctors to prescribe alternatives that are often inferior to Plan A treatments. With patient well-being on the line, healthcare regulators are scrambling to find a panacea for a problem that’s been festering since 2021.

Diagnosing a cause

Experts cite a variety of reasons for the widespread shortages:

• Surging demand can lead to scarcities for drugs like Adderall, which is being prescribed extensively via telehealth, as well as the buzzy weight-loss drug Ozempic.
• US regulations incentivize the makers of generic drugs to compete on price, diminishing the motivation for pharma companies to produce them.
• Injectables like Ozempic are manufactured through a heavily regulated, technically difficult process that can easily derail.

The Biden administration announced a $5 billion plan earlier this month that it says would help keep pharmacy shelves stocked. It aims to boost transparency in obscure pharma supply chains by tasking an independent organization with scoring manufacturers on their production resilience and quality. Private hospitals that work with reliable generic drug suppliers would be rewarded with extra cash, while those who don’t would be penalized.

The ASHP criticized the proposed penalties, arguing that hospitals that don’t have the means to comply with the requirements would take a financial hit.

Looking ahead: The plan will remain just a plan until lawmakers in Congress agree to greenlight it.—SK

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🚙 Tesla is cutting more than 10% of its global workforce. CEO Elon Musk announced the layoffs in an internal memo seen by Bloomberg. Hurt by cooling demand for electric vehicles and mounting miscues, the automaker badly missed on expectations for deliveries last quarter—its first decline since 2020. But that’s not all: Two senior executives are leaving Tesla, and the company is halting deliveries of its new Cybertruck due to an “unexpected delay.” A Cybertruck owner went viral over the weekend for detailing how his car’s accelerator pedal cover came loose and jammed the accelerator in the full-throttle position.

Samsung reclaimed its spot over Apple as the world’s top smartphone seller. Apple iPhone shipments fell 9.6% to ~50 million units in the first quarter, per the International Data Corporation, leaving the tech giant with a 17.3% share of the global smartphone market. Samsung shipments, meanwhile, fell just 0.7% to ~60 million units, putting it back in the top spot that Apple had briefly snatched earlier this year. Largely to blame for Apple’s slip back to second are its sluggish sales in China, where it faces increased competition from homegrown companies like Xiaomi.

The FBI is investigating the Key Bridge collapse. The bureau is looking into whether the crew of the Dali knew the cargo ship was experiencing system problems before it left port, the Washington Post reported. On March 26, the ship lost power and collided with the iconic Baltimore bridge, destroying it and killing six construction workers. Baltimore Mayor Brandon Scott also announced yesterday that the city hired two law firms to “hold the wrongdoers responsible.” The National Transportation Safety Board is conducting its own investigation into the cause of the incident, reportedly focusing on the ship’s electrical issues.

Today in bad news, scientists are metaphorically shaking world leaders by the lapels over alarming new evidence of a global coral reef bleaching event that threatens to be the worst in history.

Over the past year, ocean temperatures have gotten high enough to cause coral bleaching at more than 54% of the reefs on Earth, the National Oceanic and Atmospheric Administration said yesterday. That portion has been growing by ~1% per week, putting marine wildlife and coastal economies at risk of losing a critical habitat that shelters 25% of ocean life and generates ~$2.7 trillion each year by supporting tourism, storm surge protection, and fisheries, according to the International Coral Reef Initiative.

Time is of the essence. Bleached coral is starving and can only survive warm temps for one or two months. Scientists say it’s too late for small-scale restoration work—a global crackdown on greenhouse gas emissions is the only way to save some of the reefs.

This is the fourth mass bleaching in 26 years. All of them have coincided with El Niño, which compounded climate change over the past year to send ocean temps to record highs. El Niño is expected to start winding down this month, hopefully bringing coolness and color back to some reefs.—ML

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Ghost kitchens manifested during the pandemic as a savior for shuttered restaurants. Now, the delivery-only food purveyors are vanishing into the ether, the NYT reported.

Kitchen United, a large operator of ghost kitchens that received $175 million in funding and was backed by Kroger, announced it was shutting down at the end of last year. Wendy’s jammed the brakes on plans to open 700 ghost kitchens. Applebee’s closed its virtual dining option completely.

The retrenchment of ghost kitchens is partly because people missed the feeling of eating in a restaurant, but poor quality and low trust are also factors.

• MrBeast may be better at cooking up thumbnails than burgers. The YouTuber sued his ghost kitchen business partner, Virtual Dining Concepts, after thousands of negative reviews called his beef patties “revolting” and “inedible.”
• Uber Eats cast out 8,000 ghost kitchens from its listings last year over complaints that the virtual eateries lack a physical space, leaving some customers feeling they were catfished.

Not all ghost kitchens have been exorcised. Denny’s has two thriving delivery-only brands and has plans to test a third virtual establishment. Chuck E. Cheese has Pasqually’s Pizza & Wings, which offers adult-sized versions of its pizza and no contact with animatronic rodents.—DL

Stat: This is not what Dylan Thomas meant when he said do not go gentle into that good night. Americans are not sleeping well, according to a new survey from Gallup. For the first time in 23 years, more than half (57%) said they would feel better if they got more sleep. Only 42% said they get the sleep they need. And fewer and fewer Americans are getting the doctor-recommended eight hours a night: Just 26% said they get that much honk-shoo honk-shoo, down from 34% a decade ago (and 59% in 1942, back when electronic devices did not scramble your brain immediately before hitting the sack). Gallup speculates that the lack of sleep is likely driven by a decadeslong rise in stress, especially among women.

Quote: “So it’s you. Here you are.”

That was Salman Rushdie’s thought when a man rushed the stage and stabbed him 10 times, the famed author said in his first TV interview since the August 2022 attack left him blind in one eye and nearly dead. Rushdie has long said he expected someone to make an attempt on his life after then-Supreme Leader Ayatollah Khomeini issued a fatwa calling for his assassination over his novel The Satanic Verses. “I remember thinking I was dying,” Rushdie said in another interview. “Fortunately, I was wrong.”

Read: Millions of Americans could lose their subsidized internet this year. (Tech Brew)