Healthcare has a drug hoarding issue, Ochsner's VP of pharmacy says

Although the number of new drug shortages has been steadily falling since 2018, active shortages have remained above 200 for four years, according to data compiled by the American Society of Health-System Pharmacists. 

Jason Chou, PharmD, Ochsner Health's vice president of pharmacy services, told Becker's the longevity of drug shortages and the critical levels are worsening. 

"Recently, we've had some shortages that I think have been a lot more impactful," Dr. Chou said, referring to supply issues for a heart failure drug and the contrast dye shortage that sprung up in May that has since slowly resolved

His main concern is dobutamine, a blood pressure treatment that's currently in short supply because of manufacturing delays. 

"Dobutamine has been a challenge off-and-on and that's a very important drug for the treatment of heart failure patients with not a lot of other alternatives," Dr. Chou said. 

What makes a shortage worse

Factors that feed into drug shortages are workforce issues, facility shutdowns and transparency problems across the supply chain, including manufacturing and production, according to Dr. Chou. 

Sometimes, there's a clear answer to why a treatment is in short supply, such as the contrast dye shortage resulting from GE Healthcare's Shanghai facility being shut down because of COVID-19 lockdowns, which seems to be easing. When the reason for a drug shortage is a mystery, though, that's when people can react "disproportionately" and create a bigger shortage, Dr. Chou said. 

He likened it to the toilet paper shortage that coincided with the start of the COVID-19 pandemic, when people stockpiled toilet paper not because of a shortage but because they heard of a potential issue. 

"People didn't need a year's supply of toilet paper, but if you hear rumblings that toilet paper may not be available for the next couple of months, what do you do?" Dr. Chou said. "Quite honestly, I don't think the drug supply chain was immune to that, especially during the pandemic."

If health systems overreact and end up with too much product, though, he said it's difficult to transfer their supply to other hospitals because of the Drug Quality Security Act, interstate laws and Drug Enforcement Administration rules. 

Not all shortages are equal

Hints of an Adderall generic shortage could be brewing for the U.S., but some sectors are feeling the brunt of it. Drugmakers, such as Novartis' Sandoz business and Teva Pharmaceuticals, have reported Adderall supply back orders, while others have so far remained in the clear. 

The same is true for health systems and their relationship with pharmacies, Dr. Chou said. He said some retail chains are experiencing a supply issue with Adderall generics but Ochsner Health's hospitals and pharmacies haven't seen a "dramatic decrease."

That's when it's a clue to be careful to react proportionately, he said, because supply chain complexity could lengthen a retail pharmacy's shortage but keep New Orleans-based Ochsner far from any hiccups.

3 go-to solutions to drug shortages

Here's what Dr. Chou listed as his top three tips for managing a drug shortage: 

1. Be aware of global news that may not seem "at first glance" that it could lead to a supply issue, especially in China and India, where many drugs are manufactured.

2. Diversify your suppliers and follow companies such as Civica, which aims to add "essential medications to the supply chain."

3. Keep track of past orders of drugs and which of these products are "mission-critical."

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