5 ways for hospitals to better manage drug shortages during COVID-19

Hospitals and health systems nationwide are struggling with their drug shortage strategy during the COVID-19 pandemic.

The health crisis placed a significant strain on the drug supply chain, leading to warranted fears about drug shortages and their effects on patients and providers. There are many factors contributing to current shortages of drugs, including reduced global production and distribution, increased use of medications to help or try to help treat COVID-19 patients, and people stocking up on drugs.

Since these and other challenges are not likely to be resolved soon, hospital pharmacists must improve their ability to effectively manage their organizations' drug shortages during this difficult period. Here are five ways to help make this demanding task easier.

1: Keep current with shortages
Pharmacists must ensure they remain up to date with the latest developments concerning drug shortages and discontinuations. There are several good websites that actively monitor the supply chain and provide updates on shortages, including those from the FDA and American Society of Health-System Pharmacists (ASHP).

While staying current on external drug shortage data is critical, so is staying current with internal data. Pharmacists can leverage technology to enhance their management ability. There are platforms that provide pharmacists with easily accessible data about their hospitals' drug shortages and availability. This information will help pharmacists make educated decisions that can help their hospitals mitigate the ongoing impacts of shortages.

2: Track regulatory developments
To help combat the chaos unleashed on the U.S. healthcare system by the pandemic, the federal government has undertaken regulatory initiatives, including some directed toward addressing drug shortages.

For example, provisions included in the "Coronavirus Aid, Relief, and Economic Security Act" (CARES Act) are directed at shortages, notes ASHP. These include the FDA prioritizing reviewing applications for generic drugs in shortage and enhanced reporting requirements for manufacturers with drug shortages. In April, FDA announced it was temporarily permitting hospital pharmacies to compound many of the drugs in short supply

Pharmacists should work to stay abreast of new regulatory developments and understand how these developments may affect their ability to secure drugs facing shortages.

3: Monitor production and accessibility developments
While regulatory developments can help improve the ability for pharmacists to acquire and compound the drugs they need, other contributors to drug shortages include disruptions to importing of critical medications and the ability for U.S. manufacturers and distributors/wholesalers to meet demand.

In late March, the Center for Infectious Disease Research and Policy (CIDRAP) announced preliminary findings from its Resilient Drug Supply Project. Among the findings: There are more than 150 critical drugs needed for acute care within a few hours to days or patient mortality rises and many of these drugs are made, formulated, packaged, or have an active pharmaceutical ingredient (API) made in countries affected by the pandemic. The pandemic has led to curtailed production and shipment of medications in these countries and the restricting of how much countries export in the interest of maintaining enough drugs for their population.

In April, the Drug Enforcement Administration (DEA) raised production quotas for many medications used to care for patients placed on ventilators. DEA has also announced plans to increase importation of several of the drugs (e.g., ephedrine, pseudoephedrine, phenylpropanolamine). Drugmakers are issuing their own statements concerning potential shortages, with some warning of likely shortages and others pledging no shortages.

When pharmacists can effectively monitor rapidly changing developments concerning production and accessibility, they are better positioned to respond effectively.

4: Improve communication and collaboration with wholesalers and distributors
Due to the significant developments impacting the drug supply chain, the availability of many vital medications seems to experience frequent changes. This makes communication with a pharmacy's sources for medications essential. Pharmacists should maintain open lines of communication with primary wholesalers and secondary distributors and ensure these sources of medications are informed about hospitals' current inventory and the medications in highest demand.

Wholesalers and distributors should be encouraged to keep pharmacists abreast of developments that may impact the drug supply chain to ensure nothing of importance missed. Hospital pharmacists should also assess ways to collaborate better with wholesalers and distributors within and outside of their organizations to help ensure medications are directed to the sites where vital drugs are needed most.

5: Strengthen communication and collaboration with clinicians
Strong communication about shortages with affected clinicians — and other stakeholders, including administrators — is also crucial. The Institute for Safe Medication Practices (ISMP) produced a helpful document about managing a drug shortage crisis in 2010 that offers a great deal of information applicable to our current situation. It includes a section on how to establish ongoing communication with staff.

ISMP recommends that pharmacies regularly share information with clinicians. This includes information on drug shortage, causes, and expected duration; assessment of current drug availability; temporary therapeutic guidelines; and availability and safe use of alternative products. ISMP advises pharmacists to prepare and update a daily report that includes this information and use the report to keep clinicians and other stakeholders informed.

Pharmacists should also communicate and work more closely with prescribers to coordinate the most effective use and conservation of drugs in short supply.

Managing Drug Shortages: Stay Vigilant
Drug shortages were a fact of life before the health crisis. Now they are growing worse, putting increased strain on pharmacists and prescribers, particularly since some medications currently in short supply can be the difference between life and death for patients. Pharmacists must work with everyone involved in the drug supply and administration chain to minimize interferences with patient care.

As emergency physician Dr. Jeremy Samuel Faust writes in The Atlantic, "Doctors are only as good as our teams, our equipment, and our medicines. If we get the personal protective equipment we need, our teams will stay safe. If we receive much-needed equipment — tests, ventilators, IV pumps — in time, fewer of our patients will die needlessly. But if we can't provide medications that make what we do effective, all our efforts will be for naught."

Adam Orsborn, PharmD, MS, is CEO of OrbitalRX, developer of an innovative drug shortage management platform for hospital pharmacies. Adam has experience as a successful health system executive at a top academic medical center; a trusted design, development, and customer success advisor for pharmacy technology companies; and a pharmacy practice leader with extensive experience in specialty pharmacy, finance, operations, and organizational and leadership development.

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Webinars

Featured Whitepapers