Growing challenges to safety, adequacy of drug supply #ahcj13

Essential, commonplace drugs are in short supply, including morphine, epinephrine and chemotherapy agents. Those shortages have led to a greater reliance on compounding pharmacies, such as the one blamed for contaminated steroid injections that sickened more than 700 people, of whom 50 died.

In the AHCJ conference session, “From compounders to drug shortages: Covering pharmacies and pharmacists,” pharmacists described the growing challenges to the safety and adequacy of the U.S. drug supply.

Michael R. Cohen, R. Ph., M.S., president of the Institute for Safe Medication Practices, gave several reasons for drug shortages, including Medicare payment restrictions that reduce profits and FDA actions that take manufacturing plants off line. Meanwhile, people have been sickened by contaminated drugs from compounding pharmacies for years before the fungal meningitis outbreak of that resulted from the contaminated steroids.

Cohen also explained that drug shortages can lead to pharmacists giving alternative drugs that don’t have a lasting effect. Sometimes drugs can be life threatening. But drug companies and pharmacists are not the only people responsible for understanding side effects for drugs – consumers are as well.

“We’re not spending enough time learning about the downside to some of the medications we’re taking,” Cohen said. “It’s potentially dangerous and it causes readmission to the hospital.”

John Walczyk, pharmacy manager at Johnson Compounding and Wellness Center, noted that many patients depend on compounded drugs, such as infants who made need a liquid formulation.

William Churchill, M.S., R.Ph., chief of pharmacy services at Brigham and Women’s Hospital, called for more government to ensure drug safety.

“We have to make decisions on how to help patients,” said Churchill. “State boards are not prepared to do this. We need an organization that does this on our behalf.”

And drug shortages are not going to end soon. Churchill said the FDA has called it a 3-to-5-year problem, but he called that optimistic.

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