The newest threat to patient health may not be the flu or other epidemics. It could be a major shortage of prescription drugs. The shortage has reached the level of a “national public health crisis,” according to a survey conducted by the Institute for Safe Medication Practices (ISMP) this summer. Survey respondents said shortages in the past year were “the worst ever, without a glimmer of hope for any improvement in the near future.”
The survey was conducted from July to September 2010, and 1,800 healthcare practitioners participated, 68 percent of whom were pharmacists. According to the ISMP, the respondents “feel unsupported by the Food and Drug Administration (FDA) and perplexed regarding why the US is experiencing drug shortages of epic proportion that are often associated with third-world countries. Respondents clearly believe the public is severely impacted by this issue, and several suggest that the problem has risen to the level of a national public health crisis.”
Thirty-five percent of the respondents reported that their facility had experienced a near miss during the past year due to a medication suddenly not being available. Also of concern was the need to use less desirable, often expensive, unfamiliar alternative drugs-if even available. The use of alternative medicines has led to delayed treatment times for many patients, as doctors and pharmacists scrambled to find alternatives. Several respondents expressed concern over the lack of advanced warning about an impending shortage, as well as precious clinical hours lost to time-consuming activities required to manage drug shortages.
Especially troubling to survey respondents was that many of the drugs involved in the shortages are high-alert medications, such as propofol, heparin, epinephrine, morphine, neuromuscular blocking agents, chemotherapy, 50% dextrose, and parenteral electrolyte supplements. Many other drugs not on high alert but in short supply are essential and lifesaving, such as antibiotics, IV fat emulsion, and fosphenytoin.
The results of this survey have sparked a call to action. The ISMP has partnered with the American Society of Anesthesiologists (ASA), the American Society of Clinical Oncology (ASCO), and the American Society of Health-Systems Pharmacists (ASHP). The newly assembled taskforce met Friday, November 5, 2010, at the Drug Shortages Summit in Bethesda, Maryland. Representatives from the FDA and pharmaceutical manufacturers were slated to join.
“Healthcare professionals are most alarmed by the increasing volume of medications in short supply, use of unfamiliar alternative drugs, and the potential for errors, poor patient outcomes, or preventable adverse drug events,” said ISMP President Michael Cohen, RPh, MS, ScD, FASHP. “Stakeholders in the process will need to develop a strategic plan aimed at reducing the occurrence of shortages, ensuring more effective FDA oversight, and creating a comprehensive early warning system.”