Nutrient drug shortages have reached crisis proportions in the United States. Everyday US hospitals are forced to ration essential nutrients as they face multiple shortages simultaneously. This compromises healthcare and has dire consequences for the most vulnerable patients, such as premature infants who are dependent on intravenous nutrient supplementation for both their short- and long-term well-being. While nutrient shortages are threatening the lives of patients in the United States, Europe has experienced no supply issues. In fact, European doctors express surprise and confusion when informed of shortages which have become a daily reality and major part of managing patient care for American medical professionals. The US government has even resorted to authorizing the importation of certain intravenous nutrients from Norway in an effort to abate the current crisis.

Previous studies have documented the problem of chronic drug and nutrient shortages in the United States, evaluated the potential consequences of these shortages, and proposed solutions. However, the reasons for the US drug shortages remain obscure. Drug companies and the US Congress have implicated the FDA, while the FDA blames the pharmaceutical manufacturers. Others have suggested that shortages stem from issues ranging from the sourcing of raw materials, to competing demand, to poorly designed distribution networks. However, none of these answers sufficiently explains why Europe is not experiencing the same problems as the US. Why is the US facing chronic nutrient drug shortages, while European countries have ample supply and no distribution issues? In an effort to answer this question, this research takes a comparative approach, considering the regulatory framework, the national demand, the structure of the supply chain, and the economic incentives of production in the United States, Norway and Germany. Through examining the political regulation and incentive structures across cases this study aims to uncover the causes of shortages in the American market and the role of public policy in creating and potentially relieving this crisis.