Questions hospital pharmacists should ask when managing drug shortages
Tips and solutions to help when confronting the drug supply chain crisis
Drug shortages are nothing new. But studies have found that drug shortages continue at a crisis level and are on the rise in the United States; they have a profound impact on patient safety, clinical outcomes, quality control and other factors.1, 2
COVID-19 exacerbated some of the common causes of drug shortage.3 For example, manufacturing may have been affected by a reduced workforce and remote work locations. Shipments of raw materials may have been interrupted by economic or regulatory restrictions. Certain medications – such as those used during ventilation – are in short supply due to a combination of factors, including high demand.4
Many clinicians cannot directly address the root causes of medication supply disruption, but they must still find effective ways to manage them. They must do so while protecting patient safety, improving clinician productivity, and reducing drug cost and lost revenue.
Technology can help automate two key areas of medication supply management: accessing inventory and finding alternatives.
Here are a few questions hospital pharmacists can ask to assess their capabilities to manage a hypothetical drug shortage of Medication X:
- What quantity of Medication X is currently in your inventory?
- What is your organization’s usage rate of Medication X?
- Is your allocation sufficient for your patient population’s current need for Medication X?
- Which wholesalers and vendors can sell Medication X to my organization today?
- How much does Medication X cost?
- What are the potential alternatives to Medication X, backed by evidence?
- Which ones are direct alternatives and are there other safe clinical alternatives to consider?
- How much do these alternatives cost?
- How can my organization effectively communicate these changes to clinicians and caregivers?
Medication shortages are not just a pharmacy problem; addressing shortages requires action on multiple fronts. And while the pharmaceutical industry is preparing to comply with legislation to track and trace medications (i.e., the Drug Supply Chain Security Act), in the meantime healthcare provider organizations must have the right protocols in place to manage drug shortages. Their efforts to control inventory and find alternatives can affect downstream clinical implications.
- Tucker EL, Cao Y, Fox ER, Sweet BV. The drug shortage Era: a scoping review of the literature 2001-2019. Clinical Pharmacology & Therapeutics. 2020 June 10. Doi: doi.org pubmed.ncbi.nlm.nih.gov
- U.S. Food and Drug Administration. Drug shortages: root causes and potential solutions. 2019. Report updated by the FDA 2/21/20. fda.gov/media/131130/download
- Hahn SM. FDA statement: Coronavirus (COVID-19) Supply Chain Update. U.S. Food & Drug Administration. 2020 February 27. Accessed 8/20/20. fda.gov
- Rosenthal M. COVID-19 slowing, but shortages still seen in ventilator drugs. Infectious Disease Special Edition. 2020 June 17. Accessed 8/20/20.