Abstract
Drug shortages frequently and persistently affect healthcare institutions, posing formidable financial, logistical, and ethical challenges. Despite plentiful evidence characterizing the impact of drug shortages, there is a remarkable dearth of data describing current shortage management practices. Hospitals within the same state or region may not only take different approaches to shortages but may be unaware of shortages proximate facilities are facing. Our goal is to explore how hospitals in Michigan handle drug shortages to assess potential need for comprehensive drug shortage management resources. We conducted semi-structured interviews with diverse stakeholders throughout the state to describe experiences managing drug shortages, approaches to recent shortages, openness to inter-institutional engagement, ideas for a shared resource, and potential obstacles to implementation. To solicit additional feedback on ideas for a shared resource gathered from the interviews, we held focus groups with pharmacists, physicians, ethicists, and community representatives. Among participants representing a heterogeneous sample of institutions, three themes were consistent: (1) numerous drug shortage strategies occurring simultaneously; (2) inadequate resources and lead time to proactively manage shortages; and (3) interest in, but varied attitudes toward, a collaborative approach. These data provide insight to help develop and test a shared drug shortage management resource for enhancing fair allocation of scarce drugs. A shared resource may help institutions adopt accepted best practices and more efficiently access or share finite resources in times of shortage.
Highlights
The World Health Organization (WHO) characterizes drug shortages as a critical global health problem [1, 2]
Participants in our sample reported an average of 11 years of experience in handling drug shortages, with a range of 1 to 44 years
Among the participants interviewed from a variety of hospitals in Michigan, several themes were consistent: (1) numerous drug shortages strategies occurring simultaneously; (2) inadequate resources and lead time to proactively manage shortages; and (3) interest in, but varied attitudes toward, a collaborative approach
Summary
The World Health Organization (WHO) characterizes drug shortages as a critical global health problem [1, 2]. Drug shortages are caused by factors such as raw material shortages, regulatory influences, manufacturing difficulties, and financial implications [3, 4]. The American Society of Health System Pharmacists (ASHP) has reported hundreds of active shortages each.
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