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Drug shortages plague hospitals

David Gray, Douglas County Hospital pharmacist

The country's prescription drug shortage is hitting close to home.

During last month's Douglas County Hospital (DCH) board meeting, David Gray, director of pharmacy, explained the problem and detailed the impact on the hospital.


According to the U.S. Food and Drug Administration (FDA), a major reason for the drug shortages has been quality/manufacturing issues. However, there have been other reasons such as production delays at the manufacturer and delays companies have experienced receiving raw materials and components from suppliers.

Discontinuations are another factor contributing to shortages. The FDA reported that it couldn't require a firm to keep making a drug it wants to discontinue. Sometimes companies in favor of newer, more profitable drugs, according to the FDA, discontinue these older drugs.


There's a list of more than 200 drugs that are in short-supply in the U.S.

Currently, Gray said, there are about five prescription injectable drugs that the hospital can't get or can only track down a very limited supply of.

Two of those drugs are used to treat cancer patients.

Gray said one of those drugs is Doxil, which is used to treat two breast cancer patients.

"Dr. Raflores had to switch their therapy and in doing that, you're going to a different therapy... that maybe won't work quite as well, or has additional side effects," he explained.

Another drug that the hospital pharmacy is having a hard time getting hold of is Leucovorin, which is most commonly used in the treatment of colon cancer.

Gray said some local colon cancer patients have been switched to a pill rather than injections.

"They're getting the same drug, but instead of getting one injection, they have to take this drug twice a day, for three of four weeks," Gray said.

He said the injected form of Leucovorin costs $80 per dose, but the oral treatment costs patients about $5,000 per month.

"It's a cost issue," Gray said. "We had eight patients that had to switch to [oral therapy]. It's not tolerated as well as the injected form."

However, Gray explained, "We've been real lucky that the Coborn Cancer Center and the Roger Maris Cancer Center have helped us with a couple patients. They're bigger facilities... so we've been picking up the drug for patients who just cannot handle the oral form. But we have to call and beg and [those facilities] send me one dose for each patient."

Gray said, "It's costing [Douglas County Hospital] more money because the alternatives we're using are more expensive. We're stockpiling drugs because when we see there's a shortage, we're trying to get as much as we can.

"There are different drugs we can use that maybe work as well, but have more side effects," Gray said. "It's not as good an experience when they're in the hospital because they're not getting the best drug available for them."

Gray added, "This is not unique to Douglas County Hospital. Every hospital in the state is facing the same shortages."


Gray also informed the hospital board that, last February, Senator Amy Klobuchar helped introduce the Preserving Access to Life-Saving Medications Act.

The bipartisan bill would require prescription drug manufacturers to give early notification to the FDA of any incident that would likely result in a drug shortage, as well as direct the FDA to provide up-to-date public notification of any actual shortage situation and the actions the agency would take to address them.

According to Klobuchar's website, the FDA prevented nearly 200 drug shortages in 2011 due to voluntary early notifications from companies, up from 38 in 2010.

Hospital board members expressed their intent to send letters of support for Klobuchar's bill.


• The number of reported drug shortages annually has tripled from 61 in 2005 to 178 in 2010.

• Of the 127 studied shortages in 2010-11, 80 percent involved drugs delivered to patients by sterile injection, including oncology drugs, antibiotics, and electrolyte/nutrition drugs.

• The leading reasons for the reported shortages were problems at the manufacturing facility (43%), delays in manufacturing or shipping (15%), and active pharmaceutical ingredient shortages (10%).

Source: Fact Sheet: Obama Administration Takes Action to Reduce Prescription Drug Shortages in the U.S.

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Amy Chaffins

Amy Chaffins is a journalist working for the Echo Press newspaper in Alexandria, Minnesota.

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