From the pharmacist frontline
In interviews with Tufts CSDD researchers, hospital pharmacists report that drug shortages have a major impact on costs, personnel
time, and patients.
The costs associated with additional hospital pharmacy staffing are significant. A major published study on drug shortages
found that the labor cost alone to manage drug shortages is an estimated $216 million annually in the United States. The costs
associated with pharmacists, pharmacy technicians, and nurses in a 400-bed hospital (or greater) are in the range of $25,077
to $118,800 per year. One UK-based interviewee remarked that "we have to divert staff time to chasing outstanding orders and
we spend a lot of time working out alternative treatments." Some recent UK data collected by a government survey found that
43 percent of pharmacists spend two to five hours per week sourcing out-of-stock medication. In addition, some hospitals need
to increase the medication that they hold in stock as a strategy for dealing with the unreliability of certain drug supply
chains. This extra inventory adds to hospital pharmacy expenses and dollars must be re-allocated to cover these costs.
Information technology systems—in particular, large databases containing inventory data and tracking capabilities—within the
pharmacy play a key role in managing and resolving shortages. One hospital pharmacist warned, however, that there is an inverse
relationship between system sophistication and the ease with which shortages are managed. "We've found that the more sophisticated
your pharmacy drug distribution system is, the harder it is to manage shortages." Pharmacists spend a lot of unplanned time
developing alternative treatment plans. One interviewee mentioned that "every patient must receive optimal treatment. We spend
time working out alternative treatments; all guidelines have to have an alternative."
Key Survey Statistics
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The lack of published data available on patient outcomes poses difficulties when assessing the impact of an alternative drug
due to a shortage. One hospital pharmacist remarked that "when switching to another product, we may use a different concentration
of a drug and we're concerned that there may be an adverse outcome or an error that may have occurred."
Efforts by independent groups to collect evidence on patient outcomes have been ongoing. For instance, the Institute for Safe
Medication Practices (ISMP) is an independent, non-profit organization that is focused on patient outcomes and involved with
industry stakeholders in the healthcare arena. The organization is concerned with improving patient safety and has reported
on adverse patient outcomes brought about by drug shortages.
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