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Growing Shortage of Some Rx Drugs

WebMD Examines the Impact of a Shortage of Chemotherapy and Other Drugs in Hospitals and Pharmacies
By
WebMD Health News
Reviewed by Laura J. Martin, MD

Feb. 18, 2011 -- Hospitals and outpatient centers across the country are scrambling to keep supplies of many essential drugs on hand, as a shortage of some prescription drugs continues to hamper medical practice.

Last year, the Drug Information Service at the University of Utah, which tracks drug supply issues, reported shortages of 211 prescription drugs -- more than twice as many as had run short five years previously. So far, 2011 is shaping up to be even worse, with 38 new drug shortages as of mid-February, compared with just 18 for the same time period in 2010.

The types of drugs that are frequently in short supply include anesthesia and pain medications, antibiotics, and cancer chemotherapy drugs. Most of the drugs running low fall into the category of “sterile injectables” -- the kind of medications typically administered only by doctors or nurses. But in some cases, patients have had trouble getting prescriptions filled at the local pharmacy.

Chemotherapy Drug Shortage

Oncologists in particular say that the shortage of chemotherapy medications is like nothing they’ve ever seen in the past. “It’s the worst shortage we’ve experienced in three decades,” pediatric oncologist Michael Link, MD, from the Stanford University School of Medicine told the National Cancer Institute’s NCI Cancer Bulletin in January. Link is president-elect of the American Society of Clinical Oncology.

“Every hospital has been affected by this shortage,” says Gary Little, MD, medical director of the George Washington University Hospital in Washington, D.C. “It’s an everyday job making sure that we have the drugs we need. It hasn’t hit us yet to the point where we haven’t been able to get a drug at all, but I know of institutions where it has. And we were briefly out of a chemotherapy agent called cytarabine, which is used in treating leukemia and lymphoma. We had stockpiled some, but at a certain point you can’t get anymore and we ran out for a couple of days and had to use alternative chemotherapeutic agents.”

That didn’t cause any serious problems, but at some hospitals, having to switch drugs due to a shortage has led to serious side effects and even deaths. At least six people have died as a result of the prescription drug shortage, according to Michael R. Cohen, ScD, RPh, president of The Institute for Safe Medication Practices (ISMP), which published a survey of 1,800 health care professionals last fall in which one in four respondents reported adverse events as a result of the shortage.

“For example, shortages of morphine have led hospitals to use an alternative pain relief medication, hydromorphone, for which the dosing is very different. At two institutions, there were errors that resulted in patient deaths,” Cohen says. Another patient died of a pseudomonas infection when his hospital couldn’t obtain amikacin, the only antibiotic his infection was sensitive to. “And there may be more than six deaths; these are just the ones we know of from our survey,” Cohen says.

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