Drug shortage management: A qualitative assessment of a collaborative approach

Abstract

Drug shortages frequently and persistently affect healthcare institutions, posing formidable financial, logistical, and ethical challenges. Despite plentiful evidence characterizing the impact of drug shortages, there is a remarkable dearth of data describing current shortage management practices. Hospitals within the same state or region may not only take different approaches to shortages but may be unaware of shortages proximate facilities are facing. Our goal is to explore how hospitals in Michigan handle drug shortages to assess potential need for comprehensive drug shortage management resources. We conducted semi-structured interviews with diverse stakeholders throughout the state to describe experiences managing drug shortages, approaches to recent shortages, openness to inter-institutional engagement, ideas for a shared resource, and potential obstacles to implementation. To solicit additional feedback on ideas for a shared resource gathered from the interviews, we held focus groups with pharmacists, physicians, ethicists, and community representatives. Among participants representing a heterogeneous sample of institutions, three themes were consistent: (1) numerous drug shortage strategies occurring simultaneously; (2) inadequate resources and lead time to proactively manage shortages; and (3) interest in, but varied attitudes toward, a collaborative approach. These data provide insight to help develop and test a shared drug shortage management resource for enhancing fair allocation of scarce drugs. A shared resource may help institutions adopt accepted best practices and more efficiently access or share finite resources in times of shortage.

The Effect of an Iodinated Contrast Material Shortage on Ordering Patterns in the Emergency Department

“…contrast use by 50% for interventional radiology, interventional neurology, interventional cardiology, and electrophysiology [ 5 ]. Numerous statements and strategies have recently been published on addressing the ICM shortage [ 1 , 3 , 4 , 7 , 8 ]. The American College of Radiology (ACR) Committee on Drugs and Contrast Media released strategies to reduce the use of i.v.…”

“…Many health systems and institutions created comprehensive workflows to mitigate the effect of these ICM shortages. These workflows focused on decreasing iodinated contrast media utilization across different specialties such as emergency medicine, radiology, neurology, cardiology, and vascular surgery [ 4 ]. These efforts have reported contrast utilization reduction rates of up to 85% [ 1 , 5 ].…”

Patients perspectives on drug shortages in six European hospital settings – a cross sectional study

“…The indicated finding is important as healthcare and hospital policies are often inadequate (e.g. current shortage lists are often not providing the real-time shortage information or due to the legal complexities of drug borrowing/distribution, borrowing is restricted to urgent situations and never resolves the shortage) [ 32 ]. Consequently, institutions often response in isolation, uncoordinated with each other and management may differ between them.…”

Drug Shortage Crisis in US During the 21th Century: Causes, Effects, and Management Strategies

“…The author's second proposal is that the healthcare systems should have state-wide resources to share inventory and information. Undeniably, there are several barriers, such as "differing levels of perceived benefit, logistical barriers to drug sharing, sharing of proprietary information, ethical considerations about preferential drug distribution, resource maintenance, updating information into the resource, and interest of the hospital" [15]. In order to ensure the fair distribution of drugs and cohesive collaboration between hospitals, the American government should publish strict laws that forbid venal activities like rat races and stockpiling among healthcare facilities.…”