A nurse discusses medication with a patient during a house call on March 26, 2012 in Denver, Colorado. - 

A Congressional Committee today will dive deeply into the world of drug shortages. Namely why manufacturers continue to run out of cancer drugs and other medications. It turns out this is a classic healthcare problem, trying to control costs and maximize value.

Drexel Health Professor Robert Field says shortages started to crop up about ten years ago, in large part, after the feds lowered reimbursement rates for generic oncology drugs.

“The purpose was admirable, it seems that it went too far,” he says.

Field says putting the squeeze on manufacturers has prompted drug makers to look for greener pastures.

“The companies that make these drugs tend to be operating close to the margin. And if they can’t make a profit, they find a better use of their facility is to manufacture something else,” he says.

According to a new report, physicians facing shortages often change or delay dosages, sometimes even refer patients to different providers.

University of Pennsylvania oncologist Susan Domchek says that puts patient’s health at risk.  

“It is a very difficult thing to explain to a patient, why you can’t get a very standard chemotherapy regimen because you don’t have access to the medication,” she says.

The solution – ironically – may be bumping up those same reimbursements that got cut a decade ago.

Follow Dan Gorenstein at @dmgorenstein