Impact of Drug Shortages on Patient Care

Abstract

Drug shortages are a reality well known in the medical community that result in challenges in treating patients in need of those drugs. Causes of drug shortages vary from a disruption of raw materials often from foreign countries, manufacturing challenges, natural disasters, and business decisions regarding discontinuation of the production of one drug for a more profitable product. A review of literature on drug shortages revealed that there are both costly health impacts and economic losses in managing drug shortages. Patient outcomes included compromised patient care, medical errors, labor costs in finding alternative therapies, inferior alternatives, denial of treatment, rationing and hoarding supplies and price gouging. This study used descriptive and qualitative analyses to investigate the impact of drug shortages on patient care. It also explored whether the Food and Drug Administration (FDA) and the American Society of Health-System Pharmacists (ASHP) drug shortage databases are utilized in the management of drug shortages. The descriptive analysis reviewed the FDA and ASHP drug shortage lists between September 1, 2022, and December 31, 2022, to compare drugs in shortage on both lists and determine the highest ranked drugs in shortage. The qualitative analysis used semi-structured interviews between January 12, 2023, and March 31, 2023, to interview physicians and hospital pharmacists in cardiovascular medicine. The intent was to learn of their experiences in handing drug shortages, and whether the FDA or ASHP drug shortage lists are utilized in managing these shortages. The study found that the FDA drug shortage list was not used to manage drug shortages; only 50% of hospital pharmacists used the ASHP drug shortage list. Cardiovascular therapies were among the highest drugs in shortage. The most frequently discussed impact of drug shortages on patient care was labor cost. There were noted similarities and differences in the responses received from physicians and hospital pharmacists. Policy recommendations include improvements for the FDA drug shortage database to make it more usable, and further review of suitable alternatives for drugs in shortage. The limitations of the study are the study period and the urban hospital setting of study participants.