Drug shortages continue to plague hospitals across the country. According to a recent American Hospital Association survey, 99.5 percent of nonfederal hospitals experienced a shortage of one or more drugs in the past six months, and nearly half reported 21 or more drug shortages. Eighty-two percent of hospitals have delayed patient treatment as a result of a shortage, and more than half were not always able to provide a patient with a recommended treatment. The majority of all types of hospitals reported increased costs as a result of the shortages, and most are purchasing more expensive alternatives from other sources.

Shortages were most prevalent in the following treatment categories: surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrition and pain management. Forty-seven percent of hospitals experienced a drug shortage on a daily basis, 40 percent on a weekly basis and 13 percent on a monthly basis. As a result, 78 percent of hospitals surveyed implemented rationing or restrictions for drugs in short supply, and 89 percent have added backup inventory for critically important drug categories or changed par levels for drugs. Hospitals also are regularly informing medical staff of drugs in short supply, adding drugs to the pharmacy formulary as substitutes for scarce drugs and educating clinical staff about shortages and safe dosing of alternative drugs.

In a study from Premier Inc., gray market vendors — those who use unofficial, unauthorized or unintended channels to obtain goods — are offering shortage drugs to hospitals at high prices. Premier's study of nearly 2,000 unsolicited gray market offers found an average 650 percent markup on shortage drugs. The highest markups were for medication to treat critically ill patients in critical care sedation and surgery, emergency care, chemotherapy and infectious disease.

For more information on the AHA survey, go to www.aha.org/content/11/drugshortagesurvey.pdf. For the Premier report, go to www.premierinc.com.