ER drug shortages for life-saving medications on the rise

Drug shortages in hospital emergency departments have worsened, increasing more than 400 percent since 2008, according to a study published in Academic Emergency Medicine.

Researchers, led by Jesse M. Pines, M.D., an associate professor of emergency medicine and health policy at George Washington University and member of the FierceHealthcare editorial board, analyzed drug data from the University of Utah Drug Information Service over a 13-year period.

They found that nearly 1,800 drug shortages were reported between 2001 and 2014. More than half of the shortages involved lifesaving drugs and more than 1 in 3 involved drugs used in emergency rooms. The drugs most at risk for a shortage are used to treat infectious diseases, poisoning or severe pain, researchers said. Although shortages dropped between 2002 and 2007, they spiked 435 percent from 2008 to 2014.

Researchers found a number of causes for the shortages, with manufacturing delays cited as the most common, at a little more than 25 percent. The next most common were supply and demand (14.9 percent) and raw material scarcity (4.4 percent). In nearly half of the shortages studies, no reason was listed

The study did find evidence suggesting the 2008 economic crisis may have exacerbated drug shortages. "The root cause of drug shortages should be aggressively explored at the national level by policymakers, manufacturers, physician-led organizations and patient advocacy groups," the researchers wrote, with agencies such as the Food and Drug Administration (FDA) continuing "to provide high-quality, timely information about the availability of medically necessary drugs to hospital pharmacies."

The findings indicate a public health crisis, Pines told The Washington Post. The shortages  "are real, they're happening, and they're getting worse," he told the publication. More troubling, he said, is that even if emergency rooms take steps to provide alternative drug options, there is no obvious solution to the problem. 

Research in 2013 found legislation aimed at making it easier for the FDA to prevent drug shortages had had little effect, with the number of shortages virtually unchanged before and after the law's implementation, FierceHealthcare previously reported. The Government Accountability Office has expressed concerns shortages may lead to care rationing or providers substituting less effective alternatives.

To learn more:
- read the study abstract
- here's The Washington Post coverage