The current status and effects of emergency drug shortages in China: Perceptions of emergency department physicians.

Caijun Yang,Zongjie Li,Wenfang Cai,Yu Fang,Amy Theresa Page,George Liu

doi:10.1371/journal.pone.0205238

Caijun Yang, Zongjie Li + Show 4 more

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https://doi.org/10.1371/journal.pone.0205238

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Abstract

ObjectivesThe shortage of emergency drugs in China is severe. This study aimed to characterize emergency drug shortages in China and to measure their effects.MethodsAn online questionnaire based on a literature review was sent to emergency department physicians in Chinese secondary and tertiary hospitals from November 2016 to February 2017. The survey asked physicians questions about their experiences with emergency drug shortages.ResultsIn total, 236 physicians from 29 provinces participated in the survey. According to their responses, 90.7% of the respondents experienced drug shortages during the last year. More than half of the physicians (65.7%) reported that drug shortages occurred at least once a month. Hospitals in the eastern and western regions of China had more emergency drugs in shortage than hospitals in central China, especially those with many inpatient beds (≥800). In addition, the shortage situation was more serious in secondary hospitals than in tertiary hospitals. More respondents agreed that original medicines, injections, essential medicines, medicines without alternative agents and cheap medicines were more susceptible to shortages than generics, oral medicines, nonessential medicines, medicines with alternative agents and expensive medicines, respectively. Most respondents thought that drug shortages always, often or sometimes affected patients [delayed therapy (62.6%), longer rescue and recovery times (58.9%) and higher costs (58.7%)] and physicians [inconvenience (81.0%), higher pressure (76.5%) and harm to patient-doctor relationships (72%)] and compromised hospital reputations (55.1%).ConclusionsThe shortage of emergency drugs in China is serious, especially in secondary hospitals located in eastern and western China. Emergency drug shortages have significant effects on patients and physicians.

Highlights

A drug shortage refers to a situation in which a drug cannot meet the current or projected demand at the user level [1]
The shortage situation was more serious in secondary hospitals than in tertiary hospitals
More respondents agreed that original medicines, injections, essential medicines, medicines without alternative agents and cheap medicines were more susceptible to shortages than generics, oral medicines, nonessential medicines, medicines with alternative agents and expensive medicines, respectively

Summary

Introduction

A drug shortage refers to a situation in which a drug cannot meet the current or projected demand at the user level [1]. Over the last few decades, drug shortages have become a complex global health problem affecting both developed and developing countries [2]. European pharmacists across 36 countries experienced drug shortage problems in 2014, and most reported that this problem occurred on a daily or weekly basis [4]. Ireland reported shortages of 64 drugs during a four-month period with an average duration of more than two weeks [5]. Developing countries have been heavily affected by drug shortages and many of the affected drugs are essential medicines. In India, 130 medicines on the Essential Medicines List and Rationalized Drug List were reported to be in shortage in 2013 [6]. In China, researchers identified 148 drugs in shortage from 2006 to 2015, most of which were cheap and essential medicines [7]

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