Drug shortages come in all shapes and sizes. They can be caused by numerous factors and disrupt the quality of care our patients are used to. Within this blog, we will look deeper into the causes of drug shortages and what your pharmacy can do to manage them.
What is a Drug Shortage?
Let’s start off with what a drug shortage is. A drug shortage is a supply issue that affects how the pharmacy prepares or dispenses a drug product. This may also influence how the prescriber treats their patients and affects the alternatives they then prescribe.
Causes of a Drug Shortages
Caused by quality or manufacturing Issues
Caused by material shortages/ supply chain issues
Caused by increase in demand
The supply chain includes:
- producers of raw materials
- prime vendors
- group purchasing organizations
- healthcare organizations
- the patient
Factors that contribute to drug product shortages include:
- the unique market for drug products
- manufacturing and quality problems
- production delays and lack of manufacturing capacity
- manufacturer business decisions
- shortages of active pharmaceutical ingredients (APIs) or raw materials
- restricted distribution and allocation of drug products
- inventory practices
Tips to Manage Drug Shortages
- Validate details of the shortage- Knowing the details of the shortage and being able to communicate and educate your patients will be paramount to smoothly managing it.
- Questions to consider: Which particular drugs are part of the shortage? What is the expected length of time for drug shortage?
- Determine stock on hand of medication
- Questions to consider: How long will you be able to continue supplying your patients with this medication until it will run out?
- Determine alternative options
- Questions to consider: What alternative medications are available for our patients?
- Communication drug shortage to affected patients
- Identify a therapeutic alternative for affected patients
- Questions to consider: What medication will be the best substitute for patients that are currently taking this medication that is not involved in the shortage?
- Train Team Members- Ensure team members are trained on what to do in the event of a drug shortage, how to communicate information with patients, and when to reach out to providers for alternatives.
Recent Drug Shortages
According to the NCPA (National Community Pharmacists Association), about 66% of pharmacies are having trouble obtaining amoxicillin and 89% of pharmacies are experiencing a shortage of Adderall.
The cause of the shortage of Amoxicillin is unclear. Experts have been analyzing that the cause for the shortage of the antibiotic seems to be an increase in demand due to the tripledemic of COVID, RSV, and flu. Amoxicillin is one of the most commonly prescribed antibiotics due to its very broad spectrum and has been the drug of choice for many infections.
In the case of Adderall, this shortage has been reported since summer. The cause is thought to be an increase in demand during the pandemic along with the manufacturer’s intermittent manufacturing delays. Teva, one of the main companies that develop the medication is experiencing a delay due to labor shortages, and other manufacturers are not enough to meet the market demand. The supply could not catch up with the surging demand, as the prescription for the drug has been on the rise for the past 20 years. There was a 15 percent increase in the use of the drug from 2020 to 2021 among people ages 22 to 44. The stress and isolation of working from home during the pandemic could have exacerbated the symptoms or the easier affordability of the drug due to telehealth might have caused the increase. As Adderall is not an easy drug to switch and requires dose adjustment for the optimal dose, the shortage could have a huge impact on the patients.
Unfortunately, drug shortages occur and may last from days to months to years at a time. Being prepared within your pharmacy and having a plan with your team will go a long way in ensuring your patients have as little disruption in care as possible.