Shortage of psychotropic medications in community pharmacies in Saudi Arabia: Causes and solutions

Abstract

Patients with mental disorders, such as depression and anxiety, who seek medical care in private psychiatric clinics in Riyadh, Saudi Arabia, have recently expressed concerns to doctors about difficulty in filling psychotropic medications, such as Amitriptyline and Aripiprazole, at retail community pharmacies. The aim of this study was to investigate whether there is a shortage of some commonly prescribed psychotropic medications in retail community pharmacies in Saudi Arabia, and if so, to explore the possible reasons behind the shortage of these medications. The availability of 28 commonly prescribed psychotropic medications was checked in multiple retail community pharmacies in 4 different regions of Saudi Arabia. Further, potential reasons behind the shortage of some psychotropic medications in retail community pharmacies were also explored. Amitriptyline, Amoxapine, Aripiprazole, Bupropion, Buspirone, Duloxetine, Haloperidol, Hydroxyzine, Lithium, Prochlorperazine, Procyclidine, Promethazine, Thioridazine, Trazodone, and Trifluoperazine were unavailable in over half of the 248 community pharmacies surveyed. Four possible reasons behind the shortage of these medications were reported by 31 pharmacists working in different retail community pharmacies' purchasing departments, with a majority (58.06%) reporting the primary reason for a shortage of these medications that they are slow-moving items with low profit margins. The findings of this study should expedite the reform process in both the Ministry of Health and the Saudi Food and Drug Authority (SFDA) to publish and enforce an essential list of medications for retail community pharmacies, which should include the most commonly prescribed psychotropic medications.

Drug shortages in large hospitals in Riyadh: a cross-sectional study

“… 25 The hospitals were categorized into three sectors based on the structure of the Saudi health care system where governmental hospitals differ in their affiliations and sources of funding. 21 The Ministry of Health (MOH) has a separate budget where it funds all hospitals that fall under its authority. Although some medical cities belong to the MOH, they enjoy more autonomous governmental funding channeled through the MOH.…”

“…In a study that explored the scarcity of commonly prescribed psychotropic drugs, almost 50% of more than 240 community pharmacies in different regions in Saudi Arabia reported drug shortages. 21 Although drug shortages represent a significant global issue to many healthcare systems, there is a dearth of studies on the prevalence and causes in Saudi Arabia. 19 – 22 …”

National Pharmacy Inventory Management System at the Ministry of Health Institutions in Saudi Arabia

“…[16] In addition, the author found that the essential medications were missing at the community pharmacy. [15] The missing medications and lack of follow-up consequently affected patient's management care.…”

“…[7,[13][14] whereas studies regarding the status of stock inventory at the pharmacy in Saudi Arabia are scarce. [15][16] This might be because of the unclear inventory management system at the MOH institutions. The general administration of pharmaceutical care at MOH started initiative steps and established pharmacy inventory system for pharmacy in healthcare institutions including hospital or specialized centers or primary healthcare centers or dental ambulatory care clinics.…”

National Survey of Pharmacy Practice at MOH Hospitals in Saudi Arabia 2016-2017: Pharmacy Inventory Control and Stock Management

“…[4][5][6] Despite that, still there is shortage of medication at outside and inside Saudi Arabia. [7][8][9] Several studies conducted to measure the actual situation of the pharmacy inventory management system of medications at hospital pharmacies. [10][11][12] Also, the famous studies of pharmacy practice through American Society of Health-system pharmacist did not cover pharmacy stock management very well.…”