Newspaper article The Florida Times Union

Drug Shortage Alerts Hospitals Increasing Problem Places Patients at Risk, Local Officials Say

Newspaper article The Florida Times Union

Drug Shortage Alerts Hospitals Increasing Problem Places Patients at Risk, Local Officials Say

Article excerpt

Byline: Marcia Mattson, Times-Union staff writer

A growing, unprecedented shortage of hospital drugs is putting patients at risk for medication errors, surgical complications and a lack of emergency treatments, Jacksonville hospital officials say.

Officials say that in recent months, their hospitals have been having problems obtaining about 20 drugs, for a variety of reasons.

Pharmaceutical companies have stopped making some drugs in favor of more profitable drugs. And companies also have been experiencing problems in both manufacturing and in getting ingredients from suppliers.

Jacksonville hospital officials say they aren't aware of any patients harmed yet. But they say it's reasonable to expect harm is occurring because hospital staffs are scrambling to switch to other drugs, which increases the risk for medication errors.

And hospitals are turning to alternative procedures that lengthen surgery, increasing the risk of complications.

"When you have to change what you do and use something else, you often have a problem," said Tom Burnakis, Baptist Medical Center's coordinator of clinical services.

Compounding the problem are several other factors:

-- Manufacturers don't have to warn the federal government they are discontinuing a drug unless it's life-sustaining or prevents a debilitating condition, and they are the sole maker.

-- Government inspectors are not allowed to announce when drug labs are shut down for improvements after inspections.

-- Hospitals have kept shorter supplies of drugs on hand as a cost-cutting measure.

-- Panicky hospitals now are hoarding drugs, hastening shortages.

"The trend indicators are drug shortages will be with us for quite a while . . . many months to many years," said Joseph Deffenbaugh, who manages a Web site on the shortage for the American Society of Health-System Pharmacists. "It's a nightmare, isn't it?"

And even shortages of some substitute drugs are developing.

"I'm concerned we will reach a point where we can't come up with a good alternative, and I honestly do not know what we will do when that happens," said Kristina Clark, drug information practitioner for Shands Jacksonville.

The Pharmaceutical Research and Manufacturers of America, a trade group that represents drug companies, has been hearing about the shortages but hasn't been asked to study the issue, spokesman Jeff Trewhitt said.

Business decisions by the pharmaceuticals are partly to blame.

Some companies have stopped making vaccines, for instance, because they don't like government price controls or the wave of product liability lawsuits that began in the 1980s, Trewhitt said.

Companies are also scrapping the less-profitable hospital drugs, especially as their patents expire, in favor of creating and producing more lucrative outpatient drugs used for chronic illnesses, Deffenbaugh said.

Hospitals use mainly injectable drugs, which are more expensive to produce than pills because companies must maintain sterile lab conditions. Some generic drug producers don't want to spend money on new labs to begin making drugs the brand-name companies have dropped.

Wyeth-Ayerst Laboratories, which has discontinued at least four hospital drugs in recent months, reviewed its products and decided to use its limited lab space to produce new drugs, spokesman Douglas Petkus said.

"The bottom line is when you make these evaluations, you need to discontinue these products," he said.

SHORTAGES 'CRITICAL'

Area hospitals are having trouble getting several drugs.

One is injectable naloxone hydrochloride, a narcotic antagonist given in emergencies to counteract drug overdoses. Wyeth-Ayerst stopped making it, and three other labs can't meet the extra demand.

"This is critical [for patients], especially in the emergency room settings, because it will help them breathe and help them wake up," said Shands' Clark. …

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