Tahlequah Daily Press

Local News

May 4, 2012

Hospitals: Some drugs in short supply

TAHLEQUAH — Recent drug shortages are producing varied effects on local pharmacies.

Though hospital pharmacies are experiencing limited supplies of some in-patient injectable medications, over-the-counter drug stores are still able to provide their customers with the medications they need, in most cases.

“From time to time we do have shortages, but usually we figure our way around it,” said Tahlequah Medical Center Pharmacy Manager David Wilkerson. “If it’s something that there’s an alternative for that will do the same thing, then it’s going to get switched, but if it’s something that they have to have, we’ll go above and beyond to figure out where do we go to get it. It’s usually one of the hospitals where I end up having to get my stuff, through Hastings or through the city.”

According to the U.S. Food and Drug Administration, there were more than 200 drug shortages reported during 2011. These shortages, which began in 2006, arrived without warning and effected a wide range of treatment options for a variety of symptoms and illnesses from nausea and vomiting, infections, severe allergic reactions to cancer.

The shortage of a short-acting, intravenously administered hypnotic agent known as Propofol, which is used for general anesthesia, was the first major shortage experienced in hospital settings, but the problem has been corrected, said Hastings Hospital Director of Pharmacy Dr. Brandon Taylor.

“That one, by and large, has been resolved,” said Taylor. “That was the one that really got the ball rolling for us. “

The FDA released a report on information provided voluntarily by drug manufacturers that indicates shortages were due, in part, to product quality and Good Manufacturing Practices issues discovered during the processing like finding particles, microbial contamination and impurities in the final product.

Manufacturing delay and capacity issues, as well as drugmakers deciding to discontinue production of certain products have also impacted drug supplies. A small percentage is due to shortages of the raw materials, or active ingredients, used to make certain drugs.

“When some manufacturers had manufacturing problems and could not supply product, this caused other manufacturers to have to pick up the slack,” said Tahlequah City Hospital Director of Pharmacy Ray Potts “So [a certain percentage of the shortage is] due to increased demand for their products.”

Compazine, also known as Prochlorperazine, is an effective treatment for nausea and vomiting, but is unavailable due to this situation.

“Often, these shortages have occurred without warning and have required hospitals, including Tahlequah City Hospital, to take extra efforts to keep supplied with the medications involved,” he said.

Though persons receiving medical care under in-patient conditions have been impacted by these shortages, outpatient or over-the-counter needs have not been significantly affected.

“By and large, that’s true,” said Taylor.

The shortage effects experienced  in drugstore settings have impacted pricing on some children’s medications.

“Mainly for some of your ADHD meds for children, but now that’s resolved, even though the price has increased about a tenfold,” said Wilkerson. “Maybe not quite that much, but it has increased tremendously. Some of them went from $30-something  a bottle to $130-something for a bottle. Other than that, recently, I think they’ve pretty much resolved things. Every now and then something’s backordered. If they backorder something, the manufacturer usually gets it resolved pretty quick.”

Shortages of some over-the-counter products are due to product recall.

“Voltaren gel is an anti-inflammatory topical cream that they use for arthritis-type pain in the joints and it’s something a lot of our osteo doctors here in town like to write [prescriptions for] a lot and it was pretty much recalled,” Wilkerson said.

“It wasn’t necessarily a problem with that drug. It was with a drug that the same company makes. So because of that they had to pull all of their products. So I think that went the same way with Excedrin, the over-the-counter migraine medicine. That happened not long ago, and truthfully I don’t even know if that’s available now.

“I still don’t have one bottle of Excedrin on my shelves. Some generic finally came in last week, but as far as I know, [Excedrin] is not even available.”

To review current drug shortages and other related information, go to the FDA’s website at www.fda.gov and click on the tab option labeled “Drugs” or locate “Spotlight” on the same page and click on “Drug shortages.”

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What to you think of a state Legislature proposal to forbid cities from raising the minimum wage? Choose the closest to your opinion.

The federal government should set the minimum wage across the board.
States should be allowed to raise their minimum wages, but not cities.
Both states and cities should be allowed to raise their minimum wages.
Cities should be allowed to raise their mimum wages, but not states.
There should be no minimum wage at all.
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