By Milena Griffith, PharmD, BCPS
As we reported in Pulmonary Reviews Milena Griffith, PharmD, BCPS, from Midwestern University and Northwestern Memorial Hospital, Chicago, and colleagues wrote a review article published in the March Clinical Infectious Diseases about how anti-infective medication shortages can affect patient care and the measures the US government is taking to prevent deficits. Griffith elaborates on these issues in her commentary below. (You can also listen to her audiocast.) Please weigh in with your opinion on the topic in the comments.
The introduction of the HR 3839 Drug Shortage Prevention Act of 2012 marks the third legislative bill to be put before Congress regarding the issue of overall drug shortages. The large amount of attention that has been directed towards this topic is due to the increase in the number of shortages and the potential impact on patient care.
Anti-infective medications have not been spared from this onslaught of shortages. Our research group set out to quantify shortages and identify the causes. We found that most shortages are related to decreased supply and that most of the time, no reason is provided at all by the manufacturer.
A likely impact of shortages on patient care is the use of second line medications that may be inferior. Similarly, if patients are unable to receive active anti-infective therapy in a timely manner, they may have poor outcomes.
While current legislation seeks to increase the authority of the FDA in managing shortages, healthcare institutions must have a local protocol for minimizing the impact of these shortages on their patients.
Communication-based strategies are key, as well as getting the involvement of stakeholders and administration. These strategies may alleviate the impact of shortages at the local level; however, a long-term resolution must also be sought.
Clinicians should be urged to contact their legislators and provide examples from the front lines about how these shortages are impacting patient care. Action needs to be taken to halt the increasing trend of shortages and return the patient care paradigm to conventional evidence-based care.