Drug Shortage Leaves Local Pharmacists Scrambling

Depending upon the drug, many people who take medication must wait three or four days to fill their prescriptions at their local pharmacy. Those who rely on mail order pharmacies may receive their medication mere days before they’re out of drugs instead of weeks in advance.

The American Society for Health-System Pharmacists recently stated there are more than 300 medications experiencing a shortage, representing the highest level since 2014.

Pharmacists like Kaleigh Gregory at Faris Pharmacy in Rochester, have few options.

“We have people calling every week trying to find medication, multiple people,” she said.

If their suppliers do not have it in stock, the pharmacists cannot obtain it readily for their customers.

“It affects every day of our lives,” said Sarah Driscoll, doctor of pharmacy and pharmacy operations supervisor at Oswego Health, near Syracuse.

One example is Stadol, used for labor and delivery patients. Several types of chemotherapy drugs are

By Deborah Jeanne Sergeant

among those difficult to obtain.

Another is Adderall, often used to treat attention deficit hyperactivity disorder and narcolepsy. Although Oswego does not typically need Adderall for in patients, it does need it and other scarce medications for outpatients using Oswego’s retail pharmacy.

Overall, in healthcare “a lot of providers are changing for other drugs in the drug class, which causes shortages,” Driscoll said. “Patients need these lifesaving medications so we have to do what we have to to maintain a supply of them at the hospital.”

If there aren’t alternatives, that becomes a difficult issue for patients. Many want to stay on the medication they’re using, but if it’s not available, they may have to accept side effects they don’t want.

“We have some who experience a better effect for some medications for acid reflux,” Driscoll said. “They feel like one brand works better and we can’t get it in for them.”

Another strategy is talking with different suppliers to find medication. However, prices vary among suppliers. This has caused increased spending for the hospital and pharmacy. Patients with insurance should still see the same copays.

Eventually, this strategy can lead to higher premiums as insurance companies recoup their costs.

“In our world, retail pharmacies try to get whatever’s the cheapest product,” Driscoll said. “We want to be conscious of that. It negatively affects the older population that takes ‘that little white pill,’ but next filling it might be yellow or squareshaped. These shortages really affect patients.”

Lack of raw materials and workforce issues may be part of the reason drug makers aren’t supplying enough.

Driscoll said that some drug makers cease production of what they deem less popular medication. Or if a drug is approved for multiple uses, it becomes scarce as physicians prescribe it at higher rates than ever and manufacturers don’t keep up with demand.

“I know the government has been trying to help with certain committees,” Driscoll said. “The lack of expertise to dive deep into this will have to be discussed further with the

FDA and how they cannot let this happen again. I’m really concerned about these chemotherapy drugs. I don’t want people who need this lifesaving treatment but cannot get this. The government needs to subsidize these companies to hire more workers and get more drugs out to the patients.”

A new survey of cancer centers find that chemotherapy shortages are affecting most of them, prompting last-minute changes in treatment for numerous types of cancer.

About 93% of the centers surveyed said they were experiencing shortages of the drug carboplatin, while 70% were short on cisplatin. Together, these platinum chemotherapies can treat and even cure cancers, including lung, breast, prostate and many leukemias and lymphomas.

“This is an unacceptable situation. We are hearing from oncologists and pharmacists across the country who have to scramble to find appropriate alternatives for treating their patients with cancer right now,” physician Robert Carlson, chief executive officer at National Comprehensive Cancer Network, said in a news release on the widespread shortages.

“We were relieved by survey results that show patients are still able to get lifesaving care, but it comes at a burden to our overtaxed medical facilities. We need to work together to improve the current situation and prevent it from happening again in the future,” Carlson added.

The whole oncology community needs to work together on solutions, NCCN said, as it also called on the federal government, pharmaceutical industry, cancer treatment providers and insurance companies to do their part.

“The causes and solutions to the recurrent anti-cancer drug shortages that deprive oncology patients of optimal therapy are multiple and fixable. Effective solutions require a whole of oncology effort if they are to be successful,” the statement read.

In the survey, NCCN polled 27 NCCN member institutions across the United States from May 23 to 31.

By Jim Miller