Focus and Health Care

Doctors, hospitals worry about shortage of medication

November 15, 2013
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LANSING — Michigan is experiencing the nationwide problem of insufficient pharmaceutical drugs.

Hospitals, clinics and pharmacies are struggling with a lack of intravenous drugs, said Christopher Kelly, with the Office of Media Affairs for the U.S. Food and Drug Administration based in Maryland.

“We are continuing to see new shortages develop in 2013, especially of IV electrolytes and other IV drugs needed for adults and pediatric patients,” Kelly said. “These shortages have mainly occurred due to delays at one large manufacturer, and FDA is continuing to work with all of the manufacturers.”

Drug scarcity is a significant health threat that can result in serious and sometimes deadly outcomes for patients who cannot get what they need, Kelly said.

Experts say the most common pharmaceuticals they are running short of are IV components, anesthesia, chemotherapy drugs, pain medication and Adderall — which is used to treat attention deficit hyperactivity disorder.

Kenneth Elmassian, Michigan State Medical Society president and an anesthesiologist, said the unavailability of some anesthetics creates difficulties.

Laura Appel, vice president of federal policy and advocacy at the Michigan Health and Hospital Association, said patients aren’t the only ones struggling. Hospitals across the state expressed frustration with the amount of staff time and resources required to manage the inadequate amount of drugs.

Finding alternative products can be expensive and cause delays in treatment, Appel said.

One response from an informal MHA member survey observed that the situation has caused pharmaceutical care to become more difficult and costly, said Appel.

Multiple factors are responsible, said Kelly, including quality and manufacturing problems caused by lack of raw materials.

“The raw material suppliers the firms use are also limited in the amount they can make due to capacity issues at their facilities,” said Kelly. “This small number of manufacturers and limited production capacity for older sterile injectables, combined with the long lead times and complexity of the manufacturing process for injectable drugs, results in these drugs being vulnerable to insufficient quantity.”

Larry Wagenknecht, chief executive officer of the Michigan Pharmacists Association, said the number of manufacturers has dropped in the past 10 years, which is another reason for the problem.

“There’s less money and a decrease of stability for the rest of the pharmaceutical companies to fill the gap,” said Wagenknecht. “Before, when a manufacturer was out there doing a variety of things, there was always backup. Now in some of the medications, it’s down to one manufacturer that’s doing it.”

Appel said it’s nearly impossible for hospitals to prevent drug shortages because they rarely receive advance notification.

“To reduce the impact on patients, hospitals are trying many different solutions, including seeking alternative sources for drugs in short supply, increasing drug inventories, and devoting resources to train clinical staff on how to address this problem,” Appel said.

The FDA has been working with those manufacturers that are experiencing shortages to help them boost production.

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