That was the headline of an article in the February issue of H&HN. We knew as soon as the copy came in from our reporter that this was a big story. The article noted that there were 211 new drug shortages in 2010, up from 166 in 2009 and 70 in 2006. Data from the Institute for Safe Medication Practices showed that there were more than 1,000 shortage-related near misses, errors and adverse patient outcomes last summer.
The story goes on to quote experts in the field who suggest that this is the worst drug shortage in decades. Well, more evidence supporting that notion came out earlier this week. In separate surveys, the American Hospital Association and the American Society of Health-System Pharmacists reported that drug shortages are having a dramatic impact on patient safety as well as increasing costs.
The AHA survey, which was completed by 820 hospitals between June 1 and June 22, revealed some alarming data:
- 99.5% of hospitals experienced one or more drug shortages in the last six months
- 44% of hospitals had shortages for 21 or more drugs
- 47% of hospitals experienced drug shortages on a daily basis; 40% on a weekly basis
- 82% of hospitals said patient treatment was delayed as a result of a drug shortage
- 69% said patients received a less effective drug and 63% said a patient did not get the recommended treatment at all
- 92% of hospitals said drug costs have gone up as a result of shortages; 92% bought a more expensive generic alternative
There's more, but you get the point, right?
The ASHP survey is equally as startling, including this factoid: Labor costs rose $216 million nationally to deal with drug shortages. Respondents to both surveys said they do not get enough advance notice from drug manufacturers, wholesalers, distributors, GPOs, or the FDA about shortages. It's not a pretty picture. I have a family member who starts an aggressive cancer treatment next week, but according to the AHA survey, 66% of hospitals experienced drug shortages in oncology during the past six months. Now, we don't know if his drugs are in short supply, but that doesn't stop us from being even more anxious. That's one of the larger points here: patients and families are vulnerable enough when they show up at the hospital, they shouldn't be wondering if there are enough medications in the supply cabinet.
As our February article noted, many of the causes of shortages are out of a hospital's control. There are delays in bringing production back online after a recall or shutdown to prevent contamination. And then there's the issue of raw materials, many of which come from China and other foreign countries. Sometimes those shipments are contaminated or mishandled.
There is legislation pending in Congress that seeks to address some of the problems. Meanwhile, the AHA and ASHP are working together to develop some solutions, including developing an early warning system, improving communication between all stakeholders and removing regulatory hurdles faced by manufacturers and the FDA to lessen the likelihood of shortages.
These steps are important, but clearly this isn't an issue that will go away over night and the longer it persists—or worsens—the more nervous patients and families like mine will get.