Drug shortages imperil patients (Palm Beach Post)

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Drug shortages imperil patients

By Sonja Isger, Palm Beach Post Staff Writer

The nation's doctors and hospitals are grappling with a barrage of drug

shortages that has become record-setting in its scope and stands to threaten the

health of everyone seeking medical care, from intravenously fed infants to the

victims of cancer and car wrecks.

A record 211 new drug shortages were reported last year, and the shortages this

year are clocking in at a pace that doubles the one set in 2010, according to

the University of Utah Drug Information Service.

More than once, a drug shortage has forced Dr. Naryana Gowda to delay treatment

for children who came to his West Palm Beach offices with cancer. The longest

wait: about 10 days.

Across town, oncologist Dr. Green said the staff at the Palm Beach Cancer

Institute has had to scramble on several occasions to get chemotherapy drugs

that are in short supply. They've even talked about creating a priority list of

patients who would receive a scarce drug .

And the chief of anesthesiology at Palms West Hospital, Dr. ,

describes changes in the way the Loxahatchee hospital divvies up bottles of a

common operating room drug to prevent waste in an era of dwindling supplies.

" The shortage was all across medicine, but in my field it was four or five drugs

- and these weren't drugs that weren't used. They were used on a daily basis, "

said, describing shortages that for him peaked last fall.

Although hospital officials and doctors across Palm Beach County are quick to

declare that the shortage has not yet imperiled patients here, they say it

cannot be ignored.

" We don't believe the current shortages have impacted the quality of patient

care, " reads a statement from Tenet Health care in response to The Palm Beach

Post's inquiries on the crisis.

But in the same statement, Tenet, which operates five hospitals in the county,

notes it was concerned enough to create a national task force to " oversee the

dissemination of information and management protocols for drug shortages. "

Cardiologist Dr. Larry Weinstein, who is chairman of Delray Medical Center's

Pharmacy and Therapeutic Medicine Committee, said: " These shortages come up at

every meeting. It's like the atmosphere at Apollo 13 where we ask, 'How do we

fit this square peg into the round hole?'

" So on the surface it might be cause for some alarm, " Weinstein said. " The fact

is we're able to handle it. "

Hospitals in tight spot

On a national level, however, alarm bells are sounding.

" It's a public health crisis, " said Fox, who tracks the shortage data in

her job as manager of the drug information service at the University of Utah.

" There are pharmacists who do nothing all day long but try to figure out drug

supplies for their hospitals and patients, " Fox said. " They're shuffling

supplies, negotiating with other doctors to use alternatives. But sometimes

there are no alternatives. "

The drugs in short supply vary from region to region. But those that hit the

list most often are generic injectable drugs that are made by a few companies,

Fox said.

They are drugs commonly used in operating rooms, in treating cancer patients and

cardiac patients.

But they also include injectable electrolytes, which are given to patients such

as premature babies to maintain their body chemistry when they can't be fed

orally, said Bona , who coordinates the online drug shortages resource

center for the American Society of Health-System Pharmacists.

" This is affecting oncology drugs, critical-care drugs, emergency medicine

drugs, " Jensen, who heads the FDA's Drug Shortages Program, told The

Washington Post last week . " We're doing everything we can under our current

authority to try to deal with this situation. "

The local hospital officials and doctors who responded to The Post's calls knew

of no reports of patient injury or death due to a scarcity of drugs. But a

national survey of 1,800 hospital pharmacists, doctors and other health

professionals completed in September revealed that is not the case everywhere...

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