Rise in drug shortages raising alarm

SALT LAKE CITY — Scott Silverstein watches news about drug shortages as avidly as a meteorologist tracks potentially deadly storms. Recently, he's lain awake doing a mental inventory of cancer patients scheduled for treatment and the chemotherapy supplies they'll need, fretting about whether they match up.

Recent drug shortages, says Silverstein, who directs the pharmacies at Huntsman Cancer Institute and the cancer hospital, are more than troublesome.

"We got extremely close on one drug used for leukemia — so close that I thought we weren't going to make it. We've gotten so close that it scared the death out of me."

Drug shortages are becoming a fact of life, the number of them in 2010 "unprecedented," said Erin R. Fox, manager of the University of Utah drug information service. And the pace in 2011 has so far been more brisk, with nearly a new shortage a day. What worries hospitals, pharmacists, regulators, doctors and patients most is a dearth of substitutions for many of the drugs that are in short supply, including cancer, heart and arthritis treatments, among others.

"Last year, we had the most shortages ever," Fox said. "But what else is different is that on top of having more shortages, they were drugs for which we have no alternative, like some chemo drugs. If you have cancer and are being treated with a specific chemo regimen, the doctor has already done the work to know this is your best shot for a cure or prolonging life. People have had to postpone treatment or switch to medication that is less than ideal and that's incredibly concerning." Fox's service has tracked drug shortages for the American Society of Health-System Pharmacists since 2001, collecting reports mainly from hospital pharmacies nationwide. It has also tried to provide information on how to manage a shortage, but with so many medications in short supply — a high of 211 in 2010 and 89 in just the first three months of 2011 — that's a real challenge, she said.

The Washington Post reported this week that some medical centers are "rationing drugs, postponing surgeries and searching for substitutes, including some that may be less effective, have some side effects and boost the risk for overdoses and sometimes fatal errors."

"We have not had to take measures such as postponing surgeries due to this inventory shortage," said Jess Gomez, spokesman for Intermountain Medical Center. "However, we've had to be very creative in terms of ordering supplies. Our pharmacy team has done a wonderful job of using all their resources ,,, and it has been a significant challenge for them that is ongoing. So far we don't believe it has affected patient care at all, but it is a significant challenge."