How To Be Better Prepared For Drug Shortages
How To Be Better Prepared For Drug Shortages In Hospital Pharmacies BRANDON GILLIS, PHARMACY DISTRIBUTION SPECIALIST NOVANT HEALTH, INC. WINSTON-SALEM, NC 2017 NPPA CONFERENCE, LAS VEGAS, NV
Learning Objectives At the end of this session, you will be able to: Recognize different drug shortage definitions List the Food and Drug Administration (FDA) and American Society of Health-system Pharmacists (ASHP) drug shortage resources and their differences. Describe at least two methods of proactive shortage management strategies. Demonstrate the alternative purchasing pathways to execute during drug shortages. List three action plan items to mitigate the impact of active drug shortages.
What is a drug shortage? Is there a single definition for “drug shortage”?
What is a drug shortage? No! The FDA and ASHP define drug shortages differently. FDA ASHP “Manufacturers cannot meet current market demand for the drug based on information provided by manufacturers and market sales research. ” “All drug and biologic shortages reported and confirmed with manufacturer that are national in impact […] that affects how pharmacy prepares or dispenses a product or requires use of alternative drugs, which may affect patient care. ” Benjamin, B. (2014, August 29). Contrasting the FDA and ASHP drug shortage websites. Retrieved January 13, 17, from www. ashp. org/Doc. Library/Policy/Drug. Shortages/FDA-versus-ASHP. pdf
What next? Now that you have determined what a drug shortage is for your pharmacy, how do you identify a drug shortage?
Drug Shortage Identification Eliminate temporary stock outs. Verify with the wholesaler or manufacturer that no product is coming in. Introduce proactive monitoring technique(s) Wholesaler Account FDA or inventory management software resources managers and ASHP websites
What next? Now that you have determined a product is on shortage, how do you address the shortage?
Have a plan! Shortages can be unique in nature, however, having a standard operating procedure (SOP) for handling drug shortages can streamline the process quickly and efficiently. Maintain open communication channels surrounding drug shortages in your pharmacy.
Have a plan! For demonstration purposes only.
Communication Pharmacy Technicians Nurses Practitioners Drug Shortage Pharmacists Leadership
Communication Tools Standing weekly/bi-weekly calls Spreadsheet/document SBARQ Newsletters P&T Committee with status updates
SBARQ Situation/Background Medication(s) on shortage Potential release/recovery date Assessment Recommendation The impact or significance of the shortage What steps to take or changes to implement Questions Who to contact with questions.
Mitigating the Impact of Drug Shortages Technique: IV to PO conversion, automated dispensing cabinet inventory management strategies Technique: alternative procurement pathways Drop-ship Direct orders
Mitigating the Impact of Drug Shortages Order changes For example, IV medication to oral if the patient can tolerate. Automated dispensing cabinet inventory management Isolate to critical patient areas Pull back stock to your pharmacy to distribute Change delivery methods Hand-deliver medication vs. using pneumatic tube systems
Drop-ship vs. direct orders
Finding your options… Wholesaler catalog ASHP/FDA Shortages Site Manufacturer Customer Service/ Account Manager
Managing the drug shortage Verify your par levels are accurate Increase mins to be prompted for action sooner Include financial and inventory management considerations Ensure backorders are placed appropriately (i. e. exact item#) Communicate!
Drug shortage resiliency The product has become available. What next?
Drug shortage resiliency Track changes implemented during the shortage Reset pars (if applicable) Include a feedback/communication loop in your plan Monitor purchases post-shortage
Thank you! Questions?
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