With new COVID-19 outbreaks occurring across the country and the world, the concern for drug shortages is heightened. What drugs are impacted and how do they affect your organization? Do you have a contingency plan in place to deal with unexpected shortages? Work with your consultant pharmacist to resolve these issues quickly and efficiently so that patient safety and your day-to-day operations are not impacted.
We have long been aware of drug shortages and continue to be impacted by the effects of the original wave of COVID-19 cases. In May, I wrote Drug Shortages: Three Reasons Why It’s Different During COVID-19 and mentioned the Food and Drug Administration’s (FDA) announcement that famotidine was added to the shortage list. The list of medications in short supply is long and includes common medications such as anesthesia medications, antibiotics and controlled substances such as fentanyl and midazolam.
Now, as the world begins to reopen and cases start to rise again, one concern is that the lack of critical drugs will become more dire. Yes, the shortages could be more severe and last longer, but they also will start spilling over to items we never thought would be in short supply. Take dexamethasone, for example. This was a relatively inexpensive and available steroid. With recent news that it could be useful in the treatment of patients with COVID-19, it quickly became difficult to obtain.
The initial round of closures contributed to some of the shortages. Drug shortages are difficult to predict because there are so many variables involved. Some shortages, such as dexamethasone happened due to increased demand and yet others are due to a reduced supply. A new round of closures will only worsen this problem. Many medications are made in other countries and in some cases so are the raw materials to make the medications. If the pandemic causes closures in those countries, we will feel the effects in the US too.
So how do you avoid drug shortages?
There is no magic bullet here. Avoiding drug shortages altogether is nearly impossible. Navigating your way around them, is quite possible, but requires expertise. This is where your consultant pharmacist could save the day. There are various options and approaches when dealing with shortages. Last December, before we could even imagine a pandemic like this one, I wrote about Ten Steps to Dealing with Drug Shortages. There are a lot of helpful hints that will remain pertinent and should help you find some solutions. Two common recommendation I make are to be vigilant and check the list of FDA Drug Shortages. This will allow you to confirm shortages and perhaps stay ahead of the curve.
Secondly, the FDA’s Search List of Extended Use Dates to Assist with Drug Shortages will allow you to extend the expiration date on certain products, so you can continue using medications that would otherwise be considered expired. We recommend properly labeling any medication that has been extended by the FDA, or that may be unavailable, and track and document all attempts to obtain these medications. We provide a tracking tool for all our customers. Please reach out to us if you are currently not following this process or need help with a proper tracking document.
One additional option that may save the day is the use of compounding pharmacies. There are many options here, but it’s critical that you conduct due diligence prior to exercising this option. Your consultant pharmacist should guide you on properly vetting a compounding pharmacy prior to working with them. This includes verifying state licensing, FDA 503B registration, and all FDA inspection findings have been reviewed.
If you have questions or need help navigating drug shortages to avoid interruptions in care and maintain patient safety, please contact us and we will walk you through a plan specific to your facility.
The Consultant Pharmacists at OctariusRx provide guidance on safe medication management, survey readiness and cost savings to ambulatory healthcare facilities/surgery centers, senior care facilities and pharmacies We also help individual patients optimize their medications to improve their quality of life and save money. Contact us for assistance.