4 pressing drug shortages

As hospitals face dozens of drug supply issues, drug shortages have a semantics caveat, according to Erin Fox, PharmD. 

Dr. Fox is the senior pharmacy director at Salt Lake City-based University of Utah Health and a pharmacy professor at the university who helps run the American Society of Health-System Pharmacist's drug shortage website. She told Becker's that some drugmakers do not acknowledge their product is in short supply because they follow their contracts, not demand. 

"If there's not enough, that's a shortage, and I think companies should talk more about what they're doing to increase production, prevent shortages from happening and their continuity plan or what they're doing to ensure to provide those products if they have a shortage," Dr. Fox said.

As flu and respiratory syncytial virus cases slowly decline from their peak in infections, here are four key drug shortages out of the 231 that have Dr. Fox's attention: 

1. Attention-deficit/hyperactivity disorder medications, including Adderall and Ritalin: "These are very frustrating shortages because patients rely on these medications, and in many cases, they're having to try to call around to different pharmacies. Because they are controlled substances, it's a bit harder to shop around for a pharmacy. Different pharmacies are only allowed to purchase a certain amount, so with that, some pharmacies might be limiting their prescription fills."

2. Over-the-counter Tylenol, ibuprofen: "This is a really irritating shortage because when you talk to the suppliers, they think there is no shortage. And to them, there isn't, because they have made just enough product to keep all of their contracts, but they weren't expecting that demand would increase in their products."

3. Local anesthetics, including lidocaine, epinephrine and bupivacaine: These are "really basic products that we need anywhere from the OR [for] surgeries to local urgent care clinics that someone might [go to] for some stitches. These are very frustrating shortages." Dr. Fox mentioned the local anesthetics shortage in September as one of her top five shortages she is watching. 

4. Contrast products, including Isovue: "Often, clinics can't get the right size so they're ending up wasting products. The bottle might be [too high] for what the clinic might need, but because they're single use." A clinic might typically use a smaller, single-use 25 mL vial but they can only access 75 mL, Dr. Fox said, and since pharmacists cannot repackage it, "that means they end up having to waste product." 

As the antibiotic amoxicillin shortage continues, Dr. Fox said "things seem to be going OK" for penicillin supply with other strengths. Amoxicillin and penicillin are the two main treatments for strep, which is rising in the U.S.

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