Mitigating the Effects of Ongoing Drug Shortages

Novel therapies are entering the pharmaceutical market at a staggering rate—in fact, there are currently more than 8000 drugs in the development process.¹ Despite heightened therapeutic research and development, severe drug shortages continue to plague the industry.²

Beyond the inefficiencies and increased costs that shortages beget on pharmacy supply chains, they also have the potential to cause negative patient impacts. Shortages may lead to therapy changes that cause adverse medication effects, postpone or jeopardize procedures, and lead to medication errors such as illegible handwritten prescriptions, distributing incorrect medicine, miscalculating a dose, or failing to detect drug interactions.

Although drug shortages existed before COVID-19, the pandemic has undeniably aggravated the problem. In 2022, there was a massive scarcity of the commonly used antibiotic amoxicillin, and some companies increased prices on the heels of supply shortages for other desperately needed drugs, such as those required for leukemia therapy.³

These drastic fluctuations originate from many factors, including manufacturing and quality issues, supply chain interruptions, and discontinuations; however, shortages continue to be a leading cause.⁴ The ability—or lack thereof—to procure drugs can also drive prices up and decrease patient accessibility.

In 2023, there will likely be more shortages, according to an FDA warning, which mentioned shortages of more than 12 drug ingredients.⁵ There are also shortages in bacteriostatic saline, a requirement for diluting drugs for intravenous injections, and compounds used in typical drugs for anesthesia, water retention, and calcium deficiencies.

Companies and government entities have taken additional measures to mitigate the detrimental consequences of the lack of medication availability. Some states are looking to regulate drug prices. In contrast, others are hesitant, as such interventions could cut funding for the research and development of new drugs and lead to restricted innovation.⁶

Impact on Pharmacists

A recent report revealed drug shortages are the primary challenge hospital pharmacies grapple with for the fourth consecutive year.⁷ The report unveiled several staggering statistics, including:

• Hospital pharmacies are encountering 10 or more drug shortages, an increase from 62% to 76% since 2020, a noteworthy 14% increase in just a year.
• 57% of hospital pharmacists disclosed each medication shortage commonly takes 3 or more staff hours, adding more pressure to an already strained staff.

Hospital pharmacists’ time is overwhelmed with attempting to find replacements for drugs encountering shortages, trying to source new drugs from other wholesalers or manufacturers, and coming up with alternate treatment plans. To successfully address drug shortage management, one option pharmacists can turn to is new technology offerings on the market.

While assessing inventory management software, 71% of hospital pharmacists find the ability to set par levels for managing shortages an exceedingly crucial capability for any solution they are investing in.

Automated Purchasing Optimization Solutions

As the trend of hospital budget cuts prevails and labor shortages worsen, drug shortages pose an even bigger threat to operational productivity and patient safety. Hospitals must improve their shortage mitigation strategies while staff sizes are shrinking or remaining neutral. How can a hospital improve shortage response while not adding labor costs?

Automated purchasing process and analytics are the only options to streamline response, equipping users with the tools they need while minimizing human error. Hospitals must use consolidated tools and services to ensure the drug purchasing process is as modernized as possible, leveraging offerings that provide transparency to all available drug options to guarantee efficient response with minimized financial impact.

These platforms analyze numerous medication options and sources, and present focused and prioritized shortages and mitigation options. The best solutions also include blended price examinations, allowing shortage mitigation strategies to minimize the budget impact on drug and labor costs.

These solutions should include modules designed to incorporate shortage signaling regulations from the market, FDA, and American Society of Health-System Pharmacists, with supply chain data to assist facilities in organizing and reacting to relevant shortages while helping to offset the tremendous financial and operational burden of shortages.

About the Author

AJ Rivosecchi, PharmD, completed his undergraduate studies and PharmD program at the University of Pittsburgh, graduating Summa Cum Laude. He has over 10 years of hospital pharmacy experience, most recently serving as the Manager of Pharmacy Operations for UPMC St. Margaret Hospital in Pittsburgh where he championed many process improvement projects including implementing a controlled substance diversion monitoring program in conjunction with nursing leadership. AJ was active in Health System Pharmacy Operations planning and initiatives including policy review and development, chairing the UPMC Pharmacy Operations Finance committee and serving on the Health System Pharmacy Operations Construction and Diversion committees. AJ has extensive experience in all aspects of health system pharmacy operations, controlled substance management, coordinating diversion investigations, peri-operative pharmacy services and pharmacy automation.

References

1. In the Pipeline. Pharmaceutical Research and Manufacturers of America. https://phrma.org/Scientific-Innovation/In-The-Pipeline. Accessed January 24, 2023.
2. Dunleavy K. Drug shortages aren't going away any time soon, supply chain expert warns. Fierce Pharma. https://www.fiercepharma.com/manufacturing/drug-shortages-arent-going-away-any-time-soon-supply-chain-expert-warns. Published November 1, 2022. Accessed February 10, 2023.
3. Silverman E. Drugmaker raises the price of an old chemo medicine tenfold amid persistent shortages. STAT. https://www.statnews.com/pharmalot/2022/10/27/cancer-shortages-fludarabine-leukemia-chemo-areva-hospitals-pharmacy/. Published October 28, 2022. Accessed February 9, 2023.
4. Center for Drug Evaluation and Research. Drug Shortages. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages. Accessed February 9, 2023.
5. Center for Drug Evaluation and Research. Drug Shortages. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages. Accessed February 9, 2023.
6. Ginsburg P, Lieberman SM. Government regulated or negotiated drug prices: Key Design Considerations. Brookings. https://www.brookings.edu/essay/government-regulated-or-negotiated-drug-prices-key-design-considerations/. Published August 31, 2021. Accessed February 9, 2023.
7. Bluesight. Hospital Pharmacy Operations Report 2021. https://bluesight.com/wp-content/uploads/2022/03/Bluesight_2021-HPOR_Rebranded_v1-1.pdf. Accessed February 9, 2023.