Drug shortages slam patients, health workers, surveys show

Escalating shortages of vital drugs could be affecting nearly every hospital in the nation, forcing delays or substitutions in patient care, diverting pharmacy staff from crucial duties and racking up $216 million in costs to manage the situation nationwide.

That’s the take-away message of two new surveys about the impact of rising drug shortages on clinical staff and patients, conducted by the American Hospital Association and the American Society of Health-System Pharmacists.

The groups planned to hold a Capitol Hill briefing Tuesday about the consequences of the worst-ever shortage of medically necessary and life-saving drugs in the nation’s history. A coalition of cancer care organizations, concerned about a shortage of oncology drugs, plan a similar briefing on Wednesday. The groups worry that ongoing shortages of drugs, often with no warning, have been skyrocketing in recent years.

Federal Food and Drug Administration officials say the shortages are caused by manufacturing problems, firms that simply stop making drugs, and production delays.

In 2010, reported drug shortages totaled 211, up from 166 the year before and the most ever recorded. Already in 2011, 156 shortages were tallied as of June 20, according to the University of Utah Drug Information Service, which tracks the problem.

Story: When vital drugs run out, patients pay the price

“Drug shortages are a national health crisis,” said Henri R. Manasse Jr., executive vice president and CEO of ASHP, a coalition of pharmacists who practice in hospitals and health systems.

Survey: 99.5 percent of hospitals affected
Among the findings from AHA’s online survey that drew responses from 820 of the nation’s 5,100 hospitals: 99.5 percent of hospitals reported one or more drug shortages in the last six months, and nearly half reported shortages of 21 or more drugs. Some 82 percent of those hospitals said they’ve delayed patient treatment because of shortages, or have been unable to treat patients as recommended.

The ASHP survey, which drew 353 responses from 1,322 pharmacy directors, found that more than 80 percent of institutions ran low on three top vital drugs: succinylcholine injection, used to relax throat muscles to allow intubation; concentrated dextrose solutions used to mix or dilute medications; and epinephrine injections used for emergency treatment of severe allergic reactions.

The shortages have forced some clinical staff to shift away from patient duties in order to manage the problem, found the ASHP survey, which tallied the labor costs at $216 million a year nationwide.

In addition, the surveys both chronicled ongoing shortages of drugs used to for basic treatments from pain relief and sedation to antibiotics for infections and medications for cancer.

Nearly two-thirds of hospitals said they rarely receive advance notices of shortages and 14 percent never do, the AHA survey said. More than half said they're rarely told how long the shortages will last. 

The studies released this week mirror a survey this spring that showed 90 percent of anesthesiologists responding â€" some 1,373 doctors in 48 states â€" said they had experienced shortages of vital drugs. More than half had to alter their care for patients and 10 percent postponed or canceled treatments because of shortages, according to the American Society of Anesthesiologists.

Patient had to track down his own drugs
For Thomas Kornberg, 62, of San Francisco, Calif., shortages threatened to derail his treatment for Hodgkin’s lymphoma two years ago when doctors informed him they couldn’t get two of four drugs necessary for his cancer-fighting infusions.

“I was warned ahead of time, the hospital did not have an adequate supply,” said Kornberg, a professor of biochemistry and biophysics at the University of California at San Francisco. Because he had contacts in the medical field, he was able to call in favors from friends at hospitals who helped ensure his supply.

But the experience outraged him enough to prompt him to testify on Capitol Hill this week.  “These shortages could well have affected my treatment,” he said.

The issue has received attention from Congress, the Preserving Access to Life-Saving Medications Act. That bill would require drugmakers to give early notification of any incident that would likely result in a drug shortage.

Such action alone wouldn’t solve the pressing problems, said Joseph Hill, director of federal legislative affairs for the ASHP, which since November has been working with industry, government and safety groups to find a solution.

“It’s a good first start,” he said. “It’s a piece of the puzzle."

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