Drug Shortages

Resources for Drug shortages

FDA and ASHP

Most common thing to have a drug shortage

Injectables

Drug shortage; definition

Supply issue that affects how the pharmacy prepares or dispense a drug product or influence patient care when prescribers must use an alternative agent

Drug shortages can what?

Change or delay medical procedures, limit treatment options, increase cost of care

Factors contributing to shortages

* unique market
* manufacturing/quality programs
* production delays
* lack of manu capacity
* business decision
* shortages of active ingredients/raw materials
* Restricted distribution/allocation
* natural disasters

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Drug shortage team; makeup

interdisciplinary team of key staff (pharmacists, nurses, physicians) who can make decision and access info about drug shortages

Drug shortage team; purpose

* collect info about drug shortage and monitor
* develop procedures for storage, prep and dispensing
* Implement tech changes

Resource allocation committees; make-up

pharmacy, nursing, social work, medicine

Patient representative and ethics committee member

Resource allocation committees; purpose

determine patient characteristic and clinical evidence for prioritization and rationing

When are resource allocation committees required?

When shortage affect critical medication, and ethical decisions need to be made in regards to allocation

Steps to managing drug shortages

1. pharmacist/techs determine extent of drug shortage and how it will affect the hosp
2. Drug shortage team evaluates current shortage and alternative options based on safety, efficacy, availability and cost
3. Make changes to patient care process including prescribing, distribution, preparation and administration
4. Resource allocation team makes decisions on who qualifies to recieve the medication/alternative while shortage exists
5. Finalize plan and communication

Extent of shortage and affect on hospital factors

How much med is on hand, how long shortage lasts, where it is located in the hosp, possible sources of alternative meds

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Final plan; who does it need to be communicated to ?

* pharmacists
* techs
* Pharmacy buyers
* nurses
* prescribers
* med safety team
* information specialists

Shortage examples

Lorazepam IV, cefazolin IV, Pantoprazole IV