An ample drug supply is important to ensure that patients receive the medications they need. What happens if the drugs patients need are not able to be supplied for reasons that are out of our control? Drug shortages are more common than individuals think. Since 2018, there have been more than 200 ongoing drug shortages on average yearly. Pharmacists can truly help make drug shortages less of an identifiable problem. Everything that pharmacy school teaches pharmacists and pharmacy students is crucial in utilizing and strategizing the temporary or long-term solutions for these drug shortages. The figure below from the American Society of Health System Pharmacists (ASHP) website shows just how many new drug shortages are identified yearly.

Reasons for Current Drug Shortages

Drug shortages can occur for various reasons. Some of those reasons are due to manufacturing issues, the increase in demand for the product, regulatory issues, voluntary or involuntary recalls, shortage of raw materials, and economic issues. Historically, pharmacies sometimes would start to compound a product, but that is only if a product has such a solution for its shortage. For example, some chain hospitals can borrow between their sites to help relieve some of their shortages because depending on a patient population or patient volume for a given hospital, they can have a higher demand for one product over another and have the luxury to loan products between their sites.

Drug Shortages in the Workplace

Depending on certain workplaces, there can be protocols in place for what to do in case a drug becomes unavailable. Sometimes the shortage can be solved temporarily by using an alternative product, but the problem starts when there is no alternative for a given product.  For example, in an inpatient pharmacy setting in a large hospital, there can be weekly meetings in place for staff from different areas of the hospital at various administration levels to discuss drug shortages. During these drug shortage situations, it is important to have transparency between staff members. Clear communication helps create a collaborative environment which can help identify more solutions to situations. Each individual drug in shortage may need its individualized solution. Those solutions depend on the product in shortage, the facility that utilizes that product, the reason for the shortage, the return to market date, and many other factors.

Resources for Drug Shortages:

• ASHP has a whole section on its website dedicated to the drug shortage topic. It is very helpful to utilize it to stay up to date on new drug shortages. Depending on the product, it can list the reason for the shortage, and the estimated resupply dates as well. Also, ASHP has a section on the drug shortage trends that have been seen over the years. ASHP has a section on the website for resolved drug shortage items, which perhaps can be helpful to gain historical knowledge about a given product or its history with shortages.
• The Food and Drug Administration (FDA) has a whole section of its website dedicated to drug shortages. The FDA has a whole database that details breakdowns for each product on shortage in detail by the manufacturer name, shortage duration, specific NDC numbers, and anything else that might be relevant to that given product. The FDA created an app for quicker access and information regarding drug shortages as well.

Drug shortages are clearly complex and not as simple as some may think. They can be caused by various reasons. The solutions for them sometimes can be easy because there is an alternative on the market, but sometimes require a team to figure out temporary strategies and protocols such as compounding the product in pharmacies. It is important for pharmacists everywhere to have these discussions and continually educate other healthcare professionals to prepare for current and future drug shortages. Overall, drug shortages require our immediate attention and responding to the call will ensure that our patients have fewer disruptions to their treatments.

Dagmara Zajac

RxPharmacist Team

References:

1. Center for Drug Evaluation and Research. Drug shortages. U.S. Food and Drug Administration. https://www.fda.gov/drugs/drug-safety-and-availability/drug-shortages. Accessed November 23, 2022.
2. Drug Shortages Statistics. ASHP. https://www.ashp.org/drug-shortages/shortage-resources/drug-shortages-statistics?loginreturnUrl=SSOCheckOnly. Accessed November 23, 2022.
3. Drug Shortages. ASHP. https://www.ashp.org/drug-shortages?loginreturnUrl=SSOCheckOnly. Accessed November 23, 2022.
4. Ventola CL. The drug shortage crisis in the United States: causes, impact, and management strategies. P T. 2011;36(11):740-757.