Hospitals short on prescription drugs

Hospitals across the country are having to delay treatments or give patients subpar medicines because of a shortage of prescription drugs, according to a survey of American Hospital Association members.

The AHA surveyed officials at 820 hospitals and found that almost all of them reported at least one shortage over the past six months, while almost half reported 21 or more drug shortages. Separately, the American Society of Health-System Pharmacists released a study showing that managing shortages costs the country $216 million in labor costs.

The shortages are reported across all drug categories and are leading hospitals to buy more expensive alternatives. Shortages have almost tripled since 2005, according to the Food and Drug Administration, and hit a record high of 178 last year.

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According to the AHA survey, more than four fifths — 82 percent — of respondents had to delay treatment and more than half did not always give patients the recommended treatment because of shortages. Sixty-nine percent reported giving patients a less effective drug than recommended.

In addition, 77 percent of respondents said they were rarely or never notified in advance of shortages, and 67 percent weren't informed about the causes.

"The number of drugs in short supply is increasing at an alarming rate and hospitals are working diligently to reduce the impact to the patients they care for," AHA President and CEO Rich Umbdenstock said in a statement. "Clinicians need more notice about drug shortages so they have time to act to ensure that patient care is not disrupted."

The two groups are working together on recommendations, including establishing an early warning system for pending shortages; removing regulatory obstacles that may contribute to shortages; improving communications between drugmakers, hospitals and other providers; and encouraging drug production.

Reps. Tom Rooney (R-Fla.) and Diana DeGette (D-Colo.) have introduced legislation to address the shortages. Their bill would expand on current law, which requires only sole-source manufacturers of medically necessary drugs to report discontinuances to the FDA so the agency can help mitigate the disruption and notify doctors.

The Preserving Access to Life-Saving Medications Act, by contrast, would:

• Require manufacturers of all prescription drugs, including biologics, to notify the FDA of any discontinuance or interruption in the production of a drug at least six months in advance;

• Require manufacturers to notify the FDA as soon as possible in case of an unplanned discontinuance or interruption;

• Instruct the Department of Health and Human Services to publish such notifications and any actual drug shortage on its website and help distribute the information to healthcare providers and patient organizations; and

• Direct a Government Accountability Office study to examine the possible causes of drug shortages, including manufacturing problems, breakdown in supply chains and delivery systems, and restrictive regulatory requirements.