Drug Shortages Plague Healthcare Facilities While Natural Disaster Recoveries Continue

As the U.S. continues to recover from humanitarian crises caused by last year’s natural disasters, a lesser-known and far-reaching concern plagues the health care industry, specifically drug manufacturing.

Puerto Rico, one of the world’s largest centers for pharmaceutical manufacturing, is responsible for the production of 10% of all pharmaceutical products consumed in America. Damage from the storm and continued issues with power outages across the island have decreased manufacturing plant production and led to pharmaceutical shortages around the world.

Drug shortages can delay, or even deny, critically needed patient care, which is a significant public health threat and top priority for the Food and Drug Administration (FDA).

In the months since Hurricane Maria, FDA has worked extensively with Baxter International, a leading supplier of IV products. The Illinois-based company has three manufacturing plants in Puerto Rico whose production was impacted by the hurricane. As one of the highest-demand supplies in hospitals, IV saline bags recently became a particular shortage concern. Across the globe, medical facilities are now having to find alternatives for the bags, which are the most commonly used and efficient way to combat dehydration and mix and administer medications to patients.

The American Society of Health-Systems Pharmacists (ASHP) issued a Guidance Publication asking hospitals to switch to oral medications when possible, to consider alternative diluents, and to use other medication administration methods. At first glance, these appear to be easy changes. In practice, they interfere with routine processes, increasing provider burden and risk of error.

Drug shortages often lead to negative clinical outcomes due to the use of compounded products or alternative preparations. According to a 2015 journal by the South Carolina Society of Health-System Pharmacists (SCSHP), which surveyed North Carolina, South Carolina, Georgia, and Florida hospitals, drug shortages cause 1% to 5% error rates and create unsafe conditions for patients and staff 60% of the time when they occur.

The cost of care also increases due to drug shortages. According to a 2010 study by Premier Healthcare Alliance, the therapeutic substitutes used during drug shortages cost hospitals approximately $200 million annually. The 2015 SCSHP survey also showed drug shortages cause hospitals to need an average of 12 to 15 additional staff hours per week to ensure proper communication and to make updates to hospital information systems.

While FDA Commissioner Scott Gottlieb announced he expects the IV bag shortage to improve in the coming weeks, health care facilities continue to be affected. Hospitals have spent months operating in potentially unsafe conditions, using non-routine and often less-efficient and more-costly methods of care, relying on the cooperation and education of doctors, nurses, and pharmacy staff to ensure patient safety.

Hurricane Maria is just the most recent natural disaster to cause drug shortages in America. Several drugs saw significant shortages after Hurricane George in 1998 and in 2005 from Hurricanes Katrina and Rita. With many scientists projecting extreme weather conditions to only worsen around the world, there is risk drug shortages will further escalate and make the future of health care even more expensive.

It is essential that medical facilities across the country learn from situations like Hurricane Maria. They must prepare for the future by continuing to evolve and develop more efficient ways of delivering care, in every situation. Bringing awareness and developing plausible, long-term solutions to sustainable health care practices is the only way our nation will be able to continue providing quality care to those who need it.

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About the Author

Dr. Amanda Graves earned a Doctor of Pharmacy from Creighton University. She is a licensed pharmacist in Nebraska and Iowa with over 13 years of pharmacy experience. Dr. Graves started as a Pharmacist for Strategic in 2017 and is committed to the goal of protecting the future of health care for generations to come.

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