Surviving Drug Shortages: Committee Approvals
Depending on the drug-shortage profile, task forces might be created to determine what, if any, restrictions or interchanges are appropriate. Subsequently, the information is presented at the drug use committee and drug use and formulary review subcommittee of the P&T committee. Ultimately, the P&T committee reviews and accepts formulary recommendations and distributes communications about the shortage and alternatives, along with any approved restrictions. Involving key physicians who frequently prescribe the drug is helpful in developing and implementing recommendations. If time does not allow for all of these steps, an expedited review and approval process is conducted.
Physicians, nurses, and pharmacists are notified of drug shortages via several mechanisms. The primary mechanism is a direct mailing that lists the drug shortages and formulary recommendations. One-on-one interventions with prescribers also occur on a daily basis. All hospital employees also have access to the pharmacy’s intranet site, which includes a drug shortage section. A computerized A flag is also noted in the pharmacy order-entry section of the computer. When a pharmacist keys in an order for a medication on manufacturer backorder, a note will appear on the screen indicating that the inventory status of the drug is low. Drug shortage information is also posted on a pharmacy bulletin board in the central pharmacy. Occasionally, fliers are posted in key locations, such as pharmacy satellites and patient care units. When the drug shortage is over, a notice is posted to indicate this.
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Our strategies for surviving the drug shortages are most likely similar to those used by other hospital pharmacists. By attacking each of the four phases with fine detail, our pharmacy has, in the majority of cases, provided a seamless supply of drug products, despite critical shortages. Adherence to the ASHP guidelines for managing drug product shortages has provided useful recommendations for dealing with these issues. Direct computer access to wholesalers’ inventory, internet access to the World wide web, and system-wide intranet access have allowed for a real-time product availability and distribution of shortage information, respectively. Most importantly, a collaborative effort by all health care professionals, vendors, and purchasing staff has allowed our institution to address these shortages proactively, thereby ensuring that optimal patient care is provided.