Out of stock: A different kind of drug crisis

Drug shortages are a real and serious crisis in health care with critical consequences to patient care.  It is bad and it is getting worse. Some essential drugs that patients urgently need are just not available.
 
More than 80 percent of hospitals say that drug shortages have caused delays in treating patients, according to a recent survey by the American Hospital Association.  The most serious shortages include the drugs used to put patients to sleep for surgery, relieve vomiting, pain, and anxiety, treat infection, correct electrolyte abnormalities, feed patients intravenously who can’t eat, and to treat cancer. 
 
For some of these patients -- especially those with cancer, newborns and children – the situation is critical.  Drugs used to treat and possibly cure cancers are in scarce supply or not available at all.   Life-saving drugs needed by newborns are in critical short supply or unavailable. Unfortunately there are few, if any, acceptable alternatives for either of these situations.
 
And so far, the crisis only seems to be getting worse.

 
The number of new drug shortages has rapidly grown from 50 drugs in 2005 to 211 in 2010.  As of June 30, there have been 156 new shortages. This is an astounding 212 percent increase and sets a pace that may exceed 2010’s all time high.  Hospitals have scrambled for more than a year to keep essential drugs on their shelves.  And they have been doing a heroic job, as demonstrated by the relative invisibility of shortages until recently.
 
Drug shortages take a toll on hospitals and patients in another way, according to a study by the American Society of Health-System Pharmacists (ASHP) and the University of Michigan Health System (UMHS). Pharmacists are being pulled from taking care of patients so they can try to find the drugs their patients need. This can impact care as well as hospital resources, costing $211 million annually, according to theASHP/UMHS study.
 
Health care professionals dealing with drug shortages also face the challenges of constant switching among different products and using unfamiliar drugs.  For the most part, with judicious management of shortage medications and evidence-based use of alternative products, most patients have received the care they need.  But for pharmacists, physicians, and the patients we take care of, this simply isn’t good enough.  It is frustrating and discouraging to no longer have many of the drugs that are basic to care.
 
Unfortunately there are no easy short-term solutions for drug shortages.  The causes are complex. A significant first step toward resolving some drug shortages is possible through legislation introduced in Congress that requires drug firms to notify FDA as soon as possible of interruptions in product supply or discontinuations. 

The legislation, (the Preserving Access to Life Saving Medications Act--S. 296 and H.R. 2245) introduced by Sens. Amy Klobuchar (D-MN) and Robert Casey (D-PA) in the Senate and by Reps. Diane DeGette (D-CO) and Thomas Rooney (R-FL) in the House of Representatives, could go a long way toward addressing this problem.

By Henri R. Manasse, Jr., CEO of the American Society of Health-System Pharmacists and Richard J. Umbdenstock, President and CEO of American Hospital Association

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