How health systems can manage drug shortages using real-world data

The ASHP Foundation 2022 Pharmacy Forecast devotes considerable space to the issue of resilience, no surprise considering the last two years. Borrowing language from the Federal Emergency Management Agency, or FEMA, they define resilience as “a core concept in disaster risk reduction, which is the ability of health systems to prepare for, recover from, and adapt to disruption while maintaining core functions and serving the ongoing healthcare needs of their patients.”

While much of the focus of the survey, understandably, is on the role pharmacists played in the COVID-19 response, one of the most consistent and long-running forms of disruption in healthcare has been shortages of critical drugs.

It’s something that everyone who works in health system pharmacies must routinely deal with, necessitating workarounds to the disruptions to workflows and patient care. While the pandemic played a major role in disrupting drug supply chains, the number of ongoing and active shortages per year has remained above 200 since early 2018, according to ASHP, with even basic staples like sodium chloride and dextrose (IV) fluids and emergency syringes in short supply.

ASHP notes that drug shortages “can adversely affect drug therapy, compromise or delay medical procedures, and result in medication errors.” The added workload to change pharmacy automation and electronic health records to accommodate different strengths and formulations, plus the labor needed to compound new solutions, is both difficult in the face of ongoing staff shortages and raises the possibility of errors or contamination.

What is often lacking is a way to analyze data across health systems to assess the extent of the problems raised by drug shortages, including the financial impact on the health system and the degree to which they are affecting patient care and patient outcomes.

Imagine you’re contending with a shortage of a key antibiotic used to fight infections and you can’t get enough for your hospital. You’re left with a choice — either treat patients using an alternative, possibly less effective drug, or pursue a much more costly surgical treatment to attack an infection that exposes a patient to higher risk. How do you even begin to assess the extent of your problem or evaluate alternative therapies? Where do you turn?

It’s an area where Trisus Medication Compare (formerly CRCA P&T) can help.

Visibility into your drug formulary

Trisus Compare, our longitudinal real-world pharmacy claims database, offers a variety of options to provide useful information to manage a drug shortage:

  • Using Variance Reports, users can juxtapose their own data against a target facility around factors including utilization, cost and patient outcomes, so you can compare your facility’s performance against national benchmarks. Then, you can network with other hospitals to learn and implement their best practices — or publicize your own to other hospitals.
  • If you need to seek an alternative to a drug that’s in short supply, you can examine the real-world data to view costs and forecast the amounts needed to more accurately assess the financial implications to your organization.
  • Over time, you can use the POP-BUILDER tool to design a patient population treated with both the drug in short supply and the alternative medication. Then, you can compare outcomes, using average length of stay and readmissions, to see whether there was a measurable difference in outcomes between the two treatments.

Taking it a step further, imagine your pharmacy staff resorts to compounding new medications and formulations because a key drug is not available. That adds time and extra labor costs that aren’t reimbursed. So, using the drug remittance dashboard in Trisus Medication Compare, you could analyze reimbursement and margins across your drug formulary to make sure you’re not losing money elsewhere and can potentially even cover for the extra overhead for compounding through optimal margins on other drugs.

For all the problems and headaches they cause, the factors that contribute to drug shortages are many, and the fixes needed are not easy to implement in the current environment.

For now, drug shortages are a fact of life. But real-world data can help you minimize the disruptions to patient outcomes and your organization’s finances.