Generic shortages complicating pharmacists’ duties

As healthcare facilities across the nation deal with shortages of certain drugs, including generics, pharmacists and pharmacy managers are tasked with the daily monitoring of drug supplies and increased communications with other healthcare professionals such as nurses and physicians.

Drug shortages continue; hospitals cope

Drug shortages seem to be lessening, but Government Accountability Office still reports some critical ones. According to a GAO analysis, 44% of the shortages reported between June 2011 and June 2013 were generic sterile injectable drugs, and 18% of the shortages were generic orally administered drugs.

“We are seeing shortages of things such as morphine, valium, and saline. These products are not ones that have a high profit margin [for manufacturers], but we do need them,” said Erin R. Fox, PharmD, director of the Drug Information Service at University of Utah Health Care in Salt Lake City. “At hospitals, pharmacists have to be in constant contact with nurses and physicians to let them know ‘we have this in this quantity, but none of it in this.’ It’s a day-by-day thing.”

Problems with DEA

A recent GAO report partially attributes the shortages of medications such as morphine and lorazepam to incompetence by the Drug Enforcement Administration (DEA).

“Each year, manufacturers apply to DEA for quota needed to make their drugs. DEA, however, has not responded to them within the time frames required by its regulations for any year from 2001 through 2014,” the GAO report stated. However, DEA noted that its lack of compliance was due to inadequate staffing levels.

“DEA also lacks critical management information because it does not have performance measures related to setting quotas, nor does it monitor data to assess its performance,” according to the GAO report.

Drug manufacturing issues

Fox said manufacturing problems cause most of the shortages. She said manufacturers of the drugs that are often in short supply maintain tight inventories, particularly because these products do not have high profit margins. “When there is a problem, like particles in a solution or an inspection issue, there are no backup plans or other facilities prepared to supply these products.”

Fox suggests one way to reduce the shortages would be for the FDA to offer some sort of incentives to get manufacturers to expand facilities or build new ones where drugs in short supply would be produced.

Considering the persistence of the drug shortages, Fox said pharmacists and pharmacy managers should constantly monitor shortages and be proactive.

One way of doing that is through the American Society of Health-System Pharmacists. It maintains an updated list of drug shortages. “ASHP and its partners work to keep the public informed of the most current drug shortages,” the advocacy group states on its website. “Shortages can adversely affect drug therapy, compromise or delay medical procedures, and result in medication errors.”

See also:

Managing medication shortages: The pharmacist’s role

Drug shortages mobile app launched by FDA

New long-term strategies help mitigate drug shortages