Rural hospitals could soon have a harder time stocking drugs

As more drugs slip into shortage, rural hospitals could lose their failsafes as the healthcare industry grapples with dozens of inaccessible medications. 

As of March 27, eight medications made by a recently shuttered drugmaker are either backordered or discontinued in the U.S. The local anesthetic dearth is expected to persist through spring and summer. More emergency medications are unavailable, and some manufacturers said they cannot predict a resupply date. Five cancer drugs — including methotrexate, which is used to treat many cancers — are in shortage. A form of albuterol is in short supply, and manufacturers cannot meet demand for anxiety drug lorazepam. 

Rural hospitals and health systems could feel these shortages more acutely than others. 

John Bruchhaus, MD, chief medical officer of Monroe, La.-based St. Francis Medical Center, told NBC affiliate KTVE his hospital can procure medications from connections with wholesalers and larger hospitals, but St. Francis cannot help other hospitals amid the current shortages.

"In the past, we loaned a lot of these medications to some of the smaller rural hospitals when they experienced severe shortages, and unfortunately we've not been able to do that as much as we used to in the past due to us needing the medication and every bit of it that we have on the shelf," Dr. Bruchhaus said. 

During a March 22 Senate committee hearing on the risk of drug shortages, experts said rural communities could face worse care outcomes. Andrew Shuman, MD, chief of the clinical ethics service center for bioethics and social sciences in medicine for the University of Michigan Medical School in Ann Arbor, said he has "doctors and patients are truly handcuffed by the seemingly unpredictable nature of these drug shortages."

Erin Fox, PharmD, a drug shortage expert and associate chief pharmacy officer of shared services at the University of Utah's pharmacy college in Salt Lake City, said some rural hospitals are disproportionately affected because most do not have access to academic medical centers. 

"I have absolutely no idea what that supply looks like or what the workflow looks like at hospitals across the state," Dr. Shuman said. "That begets disparities; that treats people unfairly, whether that's poor people in Detroit or whether that's people in a rural hospital in Northern Michigan."

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