The Short on Competition Act makes it easier for Americans to access affordable medications when there aren't enough options available. The bill creates two main pathways to get drugs to patients faster when the market isn't competitive.

First, when there's a drug shortage and the market has very few competitors, the FDA can temporarily allow imports of safe, FDA-approved drugs from other countries for up to three years. This works by letting importers bring in drugs that are already approved and legally sold in countries like Canada, Australia, or European nations, as long as the drug manufacturer plans to eventually seek full FDA approval. The FDA has to make a decision within 60 days, and can only block imports if the drug isn't actually safe or effective.

Second, the bill defines what counts as a "marginally competitive market"—basically when fewer than five generic versions of a drug are available for at least two months in a row, and the original patent has expired. When this happens, the FDA can speed up its review process for new generic drug applications and allow temporary imports. This is designed to prevent situations where a drug becomes scarce simply because there aren't enough manufacturers competing to make it, even though it's no longer under patent protection. The goal is to keep drug prices down and ensure patients can get the medications they need without long waits or shortages.