Drug supply chainCOVID-19 Drug Shortages—and the Solutions
A new report lays out not only how the US drug supply chain has been vulnerable for years, but how those vulnerabilities are exacerbated by the COVID-19 pandemic. The report points out that 29 (72.5 percent) of the 40 critical drugs for COVID-19 patients are experiencing shortages.
In the newest “COVID-19: The CIDRAP Viewpoint” report from the Center for Infectious Disease Research and Policy (CIDRAP), researchers lay out not only how the US drug supply chain has been vulnerable for years, but how those vulnerabilities are exacerbated by the COVID-19 pandemic.
To transform what the authors call a “fail and fix” approach to a “predict and prevent” paradigm, they offer nine specific recommendations that involve a more coordinated national policy framework to track, identify, mitigate, and prevent drug shortages using a transparent database of drug supply chains. This public database would encompass all prescription drug products in the US market, and analysis of the data would focus on the most critical drugs and the consequences that would likely be experienced if there is a shortage.
Titled “Part 6: Ensuring a Resilient US Prescription Drug Supply,” the report points out that 29 (72.5 percent) of the 40 critical drugs for COVID-19 patients are experiencing shortages, according to the American Society of Health-System Pharmacists (ASHP). When these drugs are not available, healthcare providers have to consider rationing existing drug supplies, if any, finding therapeutic substitutes, or even having the patient go without treatment.
“Our focus on drug supply chains started in 2018—well before this pandemic, and what we’re seeing fits right in,” CIDRAP Director Michael Osterholm, PhD, MPH, says, referencing the center’s Resilient Drug Supply Project (RDSP), for which he is co-principal investigator (PI). RDSP scientists produced today’s report.
“At this point it’s fair to say that the pandemic is clearly showing the real challenges that the drug shortages represent,” Osterholm adds.
CIDRAP publishes CIDRAP News, but its news operation functions independently from its research efforts.
Shortages to Continue Until Supply System Changes
For some doctors, intubation-related drugs have become the rate-limiting factor for COVID-19 care, and not the ventilators or personal protective equipment (PPE, such as N95 respirators, surgical masks, and gowns) that grabbed headlines at the beginning of the pandemic.
In the spring, for instance, orders for the heart medication norepinephrine spiked by 122 percent across the nation, with Premier reporting a 421 percent increase in New York, with the supplier able to fill only 55 percent of the orders. Shortages of this drug affect COVID-19 patients, but they also affect non–COVID-19 patients who have septic shock. A 2011 norepinephrine drug shortage led to a 3.7 percent increase of the in-hospital rate of death for patients with septic shock.
