Keep focus on drug shortage crisis

On Oct. 31, 2011, President Barack Obama issued an executive order to the Food and Drug Administration to do everything possible to detect and deter drug shortages in the United States, which have been a problem for years and have recently reached record levels.

Flash forward to mid-February, when we watched the FDA scramble to avoid shortages of two critical cancer drugs, demonstrating just how real the problem is as the country was in serious danger of running out of Doxil, used to treat ovarian cancer, multiple myeloma and AIDS-related Kaposi’s sarcoma and Methotrexate, used to treat childhood leukemia.

As a short-term fix, the FDA allowed provisional shipments of Lipodox (similar to Doxil) from India, and pharmaceutical company Hospira rushed a one-month supply of Methotrexate here from a plant in Australia. The FDA is also fast-tracking an application from another pharmaceutical manufacturer to produce Methotrexate.

Although these crises were temporarily averted, none of us should rest easy.

When I speak with supply chain executives and pharmacy managers around the country, I hear two themes repeated often: the problem is not going away anytime soon and it’s costing big bucks.

Mary Selzo of Shands Healthcare in Gainsville, Fla., calls the drug shortage situation the “new normal.” She reports that the health system’s pharmacy staff spends hours every day finding alternative therapies and drugs in different forms or doses. The cost of buying drugs has increased by as much as 15 times in some cases, but the hospital pays the high prices. As Selzo puts it, “We don’t balk at the prices. We normally would split hairs, but now we have no choice.”

They have no choice because patients are in dire need of the medication, for severe pain management and often for lifesaving therapies. “We haven’t up to this point had to do anything dramatic or make a decision that comprises patient care,” said Selzo. “The worst case scenario is to not have enough doses.”

Doug Bowen, vice president of supply chain at Banner Health agrees that drug shortages are a major problem, calling the situation “a mess.”