The Burrill Report


Shortages of common medicines have reached a record high and are a nearly universal problem for community hospitals in the United States, where the problem is leading to rationing and higher costs for care.

Among 820 community hospitals surveyed by the American Hospital Association, 99.5 percent reported experiencing one or more drug shortages during the last six months and nearly half of the hospitals reported 21 or more drug shortages. The American Society of Health-System Pharmacists currently lists shortages of everything from the diabetes medication metformin to the chemotherapy drug cisplatin.

Hospitals reported experiencing drug shortages across all treatment categories, including medicines for surgery and anesthesia, emergency care, cardiovascular diseases, gastrointestinal and nutrition needs, pain management, and infectious disease. The shortages even extended to cancer drugs, which more than half the hospitals surveyed said they had run short of during the past six months.

The problem has become a major concern for hospitals. Three out of four hospitals reported rationing or implementing restrictions for drugs that are in short supply, in an effort to combat daily or weekly shortages. Many institutions say they have delayed patient treatment as a result of drug shortages and more than half were not always able to provide patients with the recommended treatment, they said.

“Drug shortages are a national health crisis,” says the Society’s executive vice president and CEO, Henri Manasse, Jr. “The impact on our health care system is enormous. It’s urgent that stakeholders work together to find solutions to this serious public health threat.”

The vast majority of hospitals surveyed reported increased drug costs as a result of drug shortages, because many are purchasing more expensive alternative drugs from other sources to combat the problem.

In a separate survey of 353 hospital pharmacy directors conducted by the Health-System Pharmacists, researchers found that labor costs associated with managing shortages cost an estimated annual $216 million in the United States.

During 2010, the number of drug shortages reached a record high, according to the U.S. Food and Drug Administration, and medicine scarcities have continued at a rapid pace in 2011.

Drug shortages are attributable to many causes, including unexpected natural disasters, regulatory actions that impact manufacturing facilities, and raw materials shortages. Occasionally manufacturers also restrict distribution to comply with post-marketing surveillance programs or to cope with unexpected demand.

Both the Society of Health-System Pharmacists and the Hospital Association are advocating for a number of legislative and regulatory actions to help address the crisis. Their shared recommendations include establishing an "early warning system" to help avert or mitigate drugs shortages; working to help the FDA streamline the approval of drugs in shortage; improving communication among stakeholders; and exploring incentives to encourage drug manufacturers to stay in, re-enter, or initially enter the market.



July 15, 2011
http://www.burrillreport.com/article-supply_of_essential_medicines_falls_short_in_u_s_hospitals.html