New List of Essential Medicines Aims to Reduce Drug Shortages

Drug shortages are affecting pharmacists across the nation, creating a burden on the pharmaceutical industry and all of the patients involved. Some companies are taking action to help pharmacists deal with this ongoing problem.

One example is Vizient, a company that provides services to the health care industry. Vizient is taking a strategic approach to lowering drug costs and shortages with the recent creation of a new Essential Medicines list.¹

Pharmacist Dan Kistner, Group Senior VP at Vizient, said that this list will help other patients and health care professionals become more aware of this issue. “I want our organization and everyone in the free market to understand that if you see a drug on this list and they stop making it, this is a problem for our patients and our country,” Kistner said in an interview with Pharmacy Times®.

The list is broken down into 3 categories: acute treatment drugs, chronic treatment drugs, and high impact medications. Each list was developed by clinical subject matter experts, in addition to using algorithms from medications featured on the World Health Organization, Advanced Cardiac Life Support, and Pediatric Advanced Life Support lists of essential medicines.¹

Although each list focuses on an important disease state, many of these options do not have any alternatives, causing more downstream effects on the patient, and greater risk of a shortage.¹

According to the FDA’s most recent Drug Shortages: Root Causes and Potential Solutions report, the reason that drug shortages persist can vary from a lack of incentives to produce less profitable drugs, logistical and regulatory challenges, and the market not recognizing and rewarding manufacturers for their quality management systems.²

The report mentions numerous ways that the FDA plans to solve these issues, such as improved data sharing, improved risk management plans, and lengthened expiration dates on products. However, the FDA still believes there is no simple solution to addressing drug shortages, and the organization suggests that these solutions will require multi-stakeholder efforts, and rethinking of business practices in order to be executed properly.²

The pharmaceutical industry has been innovating solutions and tackling diseases for years; however, the industry has not been innovating on drugs that already have a solution or optimal drug therapy, according to Kistner. “There is no incentive or motivation for some of these manufacturers to invest in clinical or therapeutic areas when there is already a gold standard therapy or drug of choice,” he added.

Kistner mentioned Vizient’s private label program, Novaplus, as a tool that works directly with generic manufacturers to help make the product reach a level of supply that hospital organizations need.³ Although the program has been successful in an acute care setting, including hospital and specialty pharmacies, Kistner said that the company is working on expanding into the non-acute market.

In addition to Novaplus, Vizient released a survey to help educate and advocate others on the hidden costs behind drug shortages. Data from the survey showed that labor cost was the top hidden cost, with the financial impact adding up to $360 million annually. Moreover, millions of clinical hours are being spent towards managing these shortages; 44% of hospitals were incurring staff overtime expenses, and 46% were managing the additional time by redistributing the workload.⁴

Kistner suggests that the health care industry must work together in order for anything to be solved. “They can’t be solved by the FDA alone, or the manufacturers alone,” Kistner said. “It is a negative impact on all involved, especially the patient, so finding ways to work together on having a consistent quality of supply of drugs in this country is so crucial to overall patient care.”

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REFERENCE

• Vizient Identifies Essential Medications in Hospitals and Highlights Fragility of the Supply Chain [news release]. Irving, TX; January 27, 2020: Vizient website. https://newsroom.vizientinc.com/press-release/clinical/vizient-identifies-essential-medications-hospitals-and-highlights-fragility-s Accessed February 7, 2020.
• Report: Drug Shortages: Root Causes and Potential Solutions (2019). FDA. https://www.fda.gov/drugs/drug-shortages/report-drug-shortages-root-causes-and-potential-solutions. Published October 29, 2019. Accessed February 4, 2020.
• Vizient. Novaplus. Vizient website. https://www.vizientinc.com/our-solutions/supply-chain-solutions/supply-chain-programs/novaplus Accessed February 7, 2020.
• New Vizient Survey Finds Drug Shortages Cost Hospitals Just Under $360M Annually in Labor Expenses [news release]. Irving, TX; June 26, 2019: Vizient website. https://newsroom.vizientinc.com/press-release/vizient/new-vizient-survey-finds-drug-shortages-cost-hospitals-just-under-360m-annuall Accessed February 7, 2020.