Wednesday, March 5, 2014

Triangle hospitals prep to combat drug shortages

Hospitals are again battling drug shortages, this time of products as common as saline solution.
At WakeMed Health & Hospitals, for example, clinical and pharmacy representatives talk to each other every day in order to determine where the shortage level stands, says WakeMed Pharmacy Manager Lynn Eschenbacher.

Drug shortages hit hospitals hard in 2011 and 2012, but seemed to come at least somewhat under control in 2013, thanks in part to federal regulations. Beginning in January, however, those shortage problems picked up again, Eschenbacher says.

Particularly for intravenous drugs to fight dehydration. One of the main culprits this year is the flu, which has been stronger than usual, according to reports from the N.C. Department of Health and Human Services. This means more people need IV fluids, and health care systems run out faster.
Eschenbacher makes clear to point out that patients aren’t in danger because there are many different kinds of IV fluids that hospital personnel can use a different kind when necessary. However, that can bring additional costs to hospitals because the varying kinds of IV treatments can come with higher price tags.

Because these shortages were happening in real time, Eschenbacher said she did not yet have a good estimate on additional costs to WakeMed.

Going back at least two years, WakeMed has held weekly meetings about drug shortages. UNC Health Care even dedicated a full-time position to managing shortages.

At area hospitals, shortages ran as high as 150 at any given time. Just a few years ago, it would have been a rarity to see more than 40 shortages a year, and those were mostly for minor drugs and only for a short time due to a minor manufacturing or shipping glitch.

The immediate cause of drug shortages can generally be traced to a manufacturer halting or slowing production to address quality problems, triggering a supply disruption, according to the U.S. Government Accountability Office, which released a report on drug shortages in February. Other manufacturers have a limited ability to respond to supply disruptions due to constrained manufacturing capacity.

That said, new regulations from the U.S. Food and Drug Administration have prevented even more shortages, the GAO reported.

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