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Critical Condition: ER Drug Shortages Putting Patients at Risk

Critical Condition: ER Drug Shortages Putting Patients at Risk
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By    |   Tuesday, 09 February 2016 03:12 PM

It’s a health emergency, but calling 911 won’t help. That’s because the crisis is a critical shortage of drugs — including some life-saving medications — in emergency rooms across the nation.

A new study by researchers at the George Washington School of Medicine and Health Sciences found that shortages are skyrocketing, increasing by more than 400 percent in recent years. And there’s no end in sight.

“During our study, there was a steady increase from 2008 to 2014, which did not appear to slow,” senior author Dr. Jesse Pines tells Newsmax Health. “While I am not certain what the trend is in 2015 and early 2016, I would guess that shortages are continuing to worsen.”

And that could be disastrous for some ER patients.

“Emergency room patients are usually in more dire circumstances than other patients,” notes Dr. Robert McNamara, Chief of Emergency Medicine at Temple University in Philadelphia. “Otherwise, they’d wait for treatment.”

One of the drugs in short supply, naloxone, is the only medication that can reverse a heroin overdose. Others include vital drugs for infectious disease, poisoning, and pain.

“The problem is that people are not always able to get the most effective drugs they need when they come to the emergency department,” says Dr. Pines, Director of the Office for Clinical Innovation at the school in Washington, D.C. “There is often an alternative medication available to treat people, but usually the second choice is not as effective or beneficial as the first choice.”

In other cases, he adds, “the life-saving medication does not have a substitute, such as snake anti-venin, which was the most common toxicology medicine on shortage in our study. If you have a serious snake bite and there is no medication available to treat you, it can worsen your outcome.”

While snake bite victims are rare, in 2014, The New York Times reported that ER doctors feared running out of injectable nitroglycerin, a commonly used drug for the initial treatment of heart attack victims. Some emergency rooms have had to conserve it.

“We’ve had to use injectable nitroglycerin carefully,” Temple University’s Dr. McNamara tells Newsmax Health. “It’s concerning when you have to go to an alternative for a long-standing drug like that. You wonder how that can happen in this country.”

A lot of people are wondering the same thing. In the case of nitroglycerin, the shortage was reportedly sparked when two manufacturers quit selling the drug due to problems with production. That left just one company to carry the full load, and it was forced to start rationing.

Apparently, the same kind of problems have limited the supply of other drugs. In the database scrutinized by the researchers, shortages were most commonly caused by factory shutdown due to quality control issues. But for nearly half of the shortages, there was no reason given.

Dr. Pines believes that some of it is just basic economics. He told the Washington Post, “This is one of the byproducts of a focus on cost in health care. There may be more demand for a medication, but it may not be in a company’s best interest to produce it because the amount they can charge is often lower than the amount it costs to manufacture it.”

And there seems to be no simple solution to the problem.

“The medical community should be aware of shortages, and when one occurs, have a clear plan for alternative medications,” says Dr. Pine. “The Food and Drug Administration does its best to prevent shortages and mitigate them when they occur, but ultimately the decision to produce enough medication to meet the market need is a business decision, which the FDA cannot directly control.”

Now, the researchers are calling for an all-hands-on-deck approach.

They conclude in their report, “The root cause of drug shortages should be aggressively explored at the national level by policymakers, manufacturers, physician-led organizations and patient advocacy groups.”


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A critical shortage of drugs - including some life-saving medications - is putting a strain on hospital emergency rooms across the nation. A new study has found that shortages have increased by more than 400 percent in recent years. And that could be disastrous for some ER patients.
emergency, room, drug, shortages, patients, risk
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2016-12-09
Tuesday, 09 February 2016 03:12 PM
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