Prescription Drug Shortages: Impact on Neonatal Intensive Care

Abstract

Background: Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics. Objectives: To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs). Methods: Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration. Results: Seventy-four of the top 100 NICU drugs were impacted by 227 shortages (10.3% of total shortages). Twenty-eight (12.3%) shortages were unresolved as of December 2016. Resolved shortages had a median duration of 8.8 months (interquartile range 3.6–21.3), and generic drugs were involved in 175 (87.9%). An alternative agent was available for 171 (85.8%) drugs but 120 (70.2%) of alternatives were also affected by shortages. Parenteral drugs were involved in 172 (86.4%) shortages, with longer durations than nonparenteral drugs (9.9 vs. 6.4 months, p = 0.022). The most common shortage reason was manufacturing problems (32.2%). Conclusions: Drug shortages affected many agents used in NICUs, which can have quality and safety implications for patient care, especially in extremely low birth weight infants. Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care.

Pediatric drug data in Canadian drug monographs: a descriptive analysis

“…20 The lack of information in monographs pertaining to the neonatal population calls for action, as critically ill infants admitted to neonatal intensive care units are exposed to a large number of medications, most of which do not have safety, efficacy and dosing information for this age group. 21,22 For almost all drugs with pediatric indications, we found an overlapping adult indication, reinforcing the available evidence that new drug approvals are mainly driven by adult standards, 17 leaving Canadian children as therapeutic orphans.…”

Pharmacists in Critical Care

“…Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care. In the context of the continuous quest to improve the care of the neonates especially the critically ill premature infants, the extended role of pharmacists in the process of parenteral nutrition order writing and effective participation in decision-making especially in the neonatal population is increasingly important [56][57][58][59][60][61].…”

Drug Shortage: Causes, Impact, and Mitigation Strategies

“…With the help of health professionals, especially pharmacists, developing countries' regulatory authorities can play their role in educating other professionals and giving awareness to the public (Caulder et al, 2015). There is a need for special training and knowledge in treating pediatric patients, especially neonates (Ziesenitz et al, 2019). Ongoing information and communication provided by clinical pharmacists on drug shortage duration resulted in a promising decrease in medication errors in the Pediatric Intensive Care Unit (ICU) (Hughes et al, 2015).…”

“…Public education and awareness through advertisements, campaigns, notices about drug shortages are also essential to correct their perceptions, rebuild their behavior (increase adherence), and trust in the healthcare system for positive outcomes (Ziesenitz et al, 2019). Patients should be aware of the availability of drugs in nearby clinics rather than general hospitals as increased patient flow to public hospitals causes drug shortages (Alsheikh et al, 2016;Alazmi et al, 2017;Walker et al, 2017).…”