Drug shortages seem to be happening with more frequency, making it difficult for patients, prescribers and facilities.  The reasons for shortages range from simple delays to manufacturing issues that can lead to complete discontinuation of some medications.  Is your facility taking the necessary steps to avoid disruptions in patient care?

This is a perfect opportunity to tap the expertise of your consultant pharmacist. There is no magic bullet and some shortages are unavoidable, but your consultant pharmacist should provide strategies to minimize the impact.

Here are the ten steps we recommend you take to avoid delays in care or even cancellation of procedures due to drug shortages:

1. Advise your entire team of the shortage situation. The earlier everyone is aware, the better your chances of discussing and implementing alternate plans.
2. Use internet resources such as the FDA Drug Shortages website to obtain drug shortage status information.
3. Consider formulary alternatives. In some cases, you may be able to proceed with another medication that is already on your formulary.
4. Consider adding therapeutic alternatives to the formulary. Being proactive could allow you to make a formulary addition prior to running out of the preferred drug.
5. Order medications from more than one source. Having more than one wholesaler or supplier available helps decrease your risk.
6. Order as early as possible. The early bird gets the worm!  Even if you don’t get it right away, you will be in the queue when the drug becomes available.
7. Look at all the available options when ordering online. Is a smaller or larger vial available?  Is an ampule available instead of a vial?   When a critical drug is in short supply, getting creative helps get the job done.
8. Check to see if an alternate brand or generic name is available. Sometimes we are searching for a brand name and the generic is available.  Other times, the opposite is true.  Trying various search names will increase your odds of finding a suitable alternative.
9. Specifically, for fentanyl injectable, remember that the 5mL vial is labeled as a single dose vial and should be treated accordingly.
10. Finally, you can consider obtaining medications from another facility. This is a risky step that requires checking with your specific state laws. Proper documentation and special caution are required when controlled substances are involved.

Taking these ten steps will go a long way to handling drug shortages and minimizing the impact to your operation.  As always, no two shortages are alike and working with your consultant pharmacist is essential to make sure you are addressing the needs of your patients while at the same time staying compliant from a regulatory standpoint.

If you have a drug shortage concern or want to be proactive before the next one happens, contact us for assistance

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.