i think also part of the issue is priorization,nd especially in life saving issues and what are agencies doing to put first things first, and what can they do to obviously redirect funds in a different direction? for -- how have cost and payment factors impacted these drug shortages 234 >> again, this is an industry that's producing products in an environment where they are facing increasing economic pressures. the profit margin for any particular agent is declining for them, so they have to make business decisions, but also keep their products moving until the decision is made, perhaps to discontinue a product or another. throwing in the quality and manufacturing issues and delay issue contributes to the situation that we're seeing now. >> who are the big payers? >> well, there's a process where purchasers hospitals, and fashions and pviders buy these products, but they are purchasing organizations and managers involved who want to drive down the price for understandable business reasons. these are all the stake holders involved in the chain. >> i do appreciate the opening testimony bec

i think also part of the issue is priorization, and especially in life saving issues and what are agenciesoing to put first things first, and what can they do to obviously redirect funds in a different direction? for -- how have cost and payment factors impacted these drug shortages 234 >> again, this is an industry that's producing products in an environment where they are facing increasing economic pressures. the profit margin for any particular agent is declining for them, so they have to make business decisions, but also keep their products moving until the decision is made, perhaps to discontinue a product or another. throwing in the quality and manufacturing issues and delay issue contributes to the situation that we're seeing now. >> who are the big payers? >> well, there's a process where purchasers hospitals, and fashions and providers buy these products, but they are purchasing organizations and managers involved who want to drive down the price for understandable business reasons. these are all the stake holders involved in the chain. >> i do appreciate the opening testimony bec

i think also part of the issue is priorization, and especially in life saving issues and what are agencies doing to put first things first, and what can they do to obviously redirect funds in a different direction? for -- how have cost and payment factors impacted these drug shortages 234 >> again, this is an industry that's producing products in an environment where they are facing increasing economic pressures. the profit margin for any particular agent is declining for them, so they have to make business decisions, but also keep their products moving until the decision is made, perhaps to discontinue a product or another. throwing in the quality and manufacturing issues and delay issue contributes to the situation that we're seeing now. >> who are the big payers? >> well, there's a process where purchasers hospitals, and fashions and providers buy these products, but they are purchasing organizations and managers involved who want to drive down the price for understandable business reasons. these are all the stake holders involved in the chain. >> i do appreciate the opening testimony b