When the sedative propofol was frequently in shortage between 2009 and 2014, the scarcity forced hospitals across the country to cancel surgeries as pharmacists struggled to obtain a supply.
The propofol shortage was resolved last summer and the number of new drug shortages has dropped. But there were still 190 drugs in active shortage as of the end of the third quarter of 2015, according to the American Society of Health-System Pharmacists, or ASHP. Many of the items listed in the group's drug shortage database are critical for hospitals, including pre-filled epinephrine syringes placed in cardiac crash carts and vital antibiotics such as meropenem.
Most hospitals rely on their group purchasing organization to ensure steady pharmaceutical supplies. But a shortage at a GPO's contracted manufacturers can leave the GPO and its members scrambling to find other suppliers or alternative therapies. These shortages, often caused by manufacturing capacity or quality problems, can create medical crises for patients.
Lee Perlman, president of the Greater New York Hospital Association's group purchasing arm, said such drug shortages too often have left his business unable to fulfill its core mission—ensuring predictable supplies at a predictable price to hospital customers. It's a big failure “if a patient lying in bed is waiting for operations that can't go forward because there's a drug shortage,” he said.
To facilitate a reliable pharmaceutical supply, GPOs spend a significant amount of time looking for alternative drugs and working to contract for those drugs. They use various strategies to get around shortages, such as promising manufacturers volume, forging long-term or exclusive deals, creating their own private drug labels, and even scouting out raw material suppliers to work with manufacturers on high-demand drugs.
Drug shortages are estimated to cost U.S. hospitals at least $200 million annually because of the higher cost of substitute drugs, according to a 2010 survey from Premier, a Charlotte, N.C.-based group purchasing and performance improvement company. An ASHP report estimated that labor costs related to the shortages cost hospitals an additional $216 million each year. These reports were released at about the same time as the drug shortage crisis hit its peak in 2011.