October 6, 2011

VUMC addresses impact of critical drug shortages

VUMC addresses impact of critical drug shortages

Periodic drug shortages at Vanderbilt University Medical Center, in line with a nationwide trend, have increased significantly in frequency and intensity over the past two years.

“The shortages often involve generic drugs that are part of basic treatment regimens, including heparin, morphine, electrolytes and several oncology agents,” said Michael O'Neal, D.Ph., manager of pharmaceutical procurement.

Drug shortages have long been in the news, but recent reports in national publications have brought the issue to broader attention and increased concern among both caregivers and their patients who receive critical drug therapy.

At a recent meeting of the Medical Center Medical Board, Vanderbilt Pharmaceutical Services administrators reported on the scope of periodic shortages at VUMC and outlined the strategies Vanderbilt is using to address the problem.

Avoiding and mitigating these shortages involves a great deal of work behind the scenes. Pharmacy procurement staff work closely with the Pharmacy & Therapeutics Committee, clinician leadership and operational staff.

In most cases the Vanderbilt pharmacy, through recourse to various industry relationships, has been able to dodge shortages. Often these supplies arrive with little time to spare.

“In other cases, when a drug is simply not available, another therapeutically equivalent agent can be used with minimal or no impact on treatment. In rare instances, patient treatment protocols must be modified because the preferred drug is not available,” O’Neal said.

Lack of consistent, accurate information from drug manufacturers and distributors makes dealing with shortages more difficult. For alerts about shortages, the pharmacy monitors websites of the Food and Drug Administration and the American Society of Health-System Pharmacists.

The pharmacy communicates shortages across VUMC through the hospital order entry system, through email, and through direct communication with clinical leaders, clinicians and staff. In special situations where it’s known that an important drug will be in short supply, the pharmacy consults clinical leaders for guidance in planning and communication.

“We continue to evaluate the best methods to provide real time information on the status of drug shortages that impact VUMC,” O’Neal said.

Staff and patients with questions or concerns regarding drug shortages are invited to contact the pharmacist serving their area, or O'Neal at michael.oneal@vanderbilt.edu.