Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States

Abstract

Background:Drug shortages have become all too common and affect all aspects of the health care delivery system. The increased number of drug shortages has had a negative impact on patient care as well as costly financial implications. Objectives: This article identifies the current problems and negative outcomes drug shortages have caused and provides a framework for how to best prepare for and combat future shortages. It highlights specific problems faced by health care system pharmacies in the Southeastern United States and the managerial responses to address these shortage situations. Methods: A 34-question, multiple-choice survey was distributed to pharmacy directors in North Carolina, South Carolina, Georgia, and Florida. Results: Of 549 surveys distributed, 219 (40%) responses were received. Respondents reported that drug shortages cause 1% to 5% error rates in hospitals and that 60% of the time drug shortages create unsafe conditions for patients and staff. Many of the respondents reported a 300% to 500% markup on medications on the shortage list. Seventy-six percent of institutions have autosubstitutions for drug shortages that have been preapproved by Pharmacy & Therapeutics Committees. Conclusions: The causes of drug shortages are multifaceted, and the safety and financial implications can be costly. In the short term, health care institutions can utilize pharmacists to assist in circumventing the drug shortage problem. The combined efforts of all health care professionals, the US government, manufacturers, and the lay public are necessary to bring awareness and plausible solutions to the drug shortage problems in the long term. Impact of Drug Shortages cardiovascular agents are common. [3][4][5][6] The primary causes for these shortages include inadequate raw materials, decreased number of manufacturers, and other factors that cause production to stall or be terminated. 7,8 Delayed or lack of communication among the FDA, manufacturers, and health care providers may contribute to the inadequate preparation in managing drug shortages. 1 The impact of drug shortages is multifaceted, with over 50% of health care practitioners believing that shortages have influenced practice and resulted in inferior patient care. 9 A Canadian study from Hall et al relayed anesthesiologists' opinions that drug shortages were responsible for prolonged recovery times, delayed surgical procedure scheduling, and increased recovery cost. Nearly half of them (49%) felt shortages were the impetus for the administration of inferior anesthetics. 6 Drug shortages often impact vulnerable populations including cancer patients or neonates, for whom few, if any, equivalent alternatives exist; shortages may result in clinical complications, as exemplified by selenium shortages. 10-13 Drug shortages may also force practitioners to prescribe infrequently used medications and concentrations, which can lead to medication errors as demonstrated with prior fentanyl shortages. 6 Drug shortages have also impacted life outside of patient...

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