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Hospitals are struggling to overcome various drug shortages


Shortages of drugs, ranging from lifesaving chemotherapies to basic generics, plague the health care system. NPR's Sydney Lupkin reports on how hospitals are adapting to chronic interruptions in the supply of key medicines.

SYDNEY LUPKIN, BYLINE: Jason Chou is a pharmacist. He didn't major in international relations. But a few days after the Hamas attack threw the Middle East into chaos, he and his colleagues at Ochsner Health in New Orleans started thinking about drug shortages.

JASON CHOU: We have to look and say, well, is there production of any kind coming out of Israel?

LUPKIN: So far they're concerned about a handful of items, but nothing has caused a problem yet. Chou has been trying to anticipate drug shortages so his hospital can have enough product stocked to weather whatever storm comes their way. And sometimes it is a literal storm. A tornado wiped out a Pfizer warehouse of drugs just this past summer, a bunch were already in short supply. There are 243 different drug shortages, according to the American Society of Health System pharmacists. Here's Michael Ganio, senior director of pharmacy practice and quality with ASHP.

MICHAEL GANIO: Some of them involve oncology drugs, things we use to treat cancer. And of course, those patients are already going through a personal struggle.

LUPKIN: Oncology isn't the only part of the hospital missing crucial medications. When a patient's heart stops beating or they stop breathing, hospitals call a code blue. That prompts medical staff to rush with a crash cart to revive the patient. But for years, there have been crucial drug shortages of things the crash cart is supposed to have stocked like painkillers, overdose reversers, simple saline bags and more. Here's Aisha Terry, president-elect of the American College of Emergency Physicians.

AISHA TERRY: This is when, you know, you are moving and shaking to make sure that we can help maintain life. And when we go to that crash cart in the middle of an emergency and can't find the medications that we need, it really is not only a failure of the system, but absolutely a failure to that patient, who came to us seeking help with literally sustaining their life.

LUPKIN: Sometimes shortages hit patients who are seeking relief for chronic pain. Pauline Cass, pharmacy manager at Stoughton Hospital in Stoughton, Wis., spoke to NPR one afternoon in September about patients awaiting steroid injections for joint pain.

PAULINE CASS: We have zero vials, and we have six patients scheduled in the next two weeks who need the radiologists to use that injectable when they do joint injections.

LUPKIN: So far they haven't had to turn anyone away because they've been able to find the drug, but appointments were delayed. A recent survey of health care workers by the Equity Institute found that shortages are compromising patient care. They were sometimes unable to give patients the best drug for their condition, had to delay care and even made medical errors. About half of the hospital workers ASHP surveyed this past summer said they were having to work overtime to cope with the shortages. Hospitals are also spending more money on drugs. That's because shortages sometimes force them to buy drugs outside their usual supply contracts. Here's Chris Laman, vice president of strategy for Columbia Memorial Hospital in Astoria, Ore.

CHRIS LAMAN: The same drug just made by a different manufacturer can cost us, you know, double or triple the amount that we'd be spending if we were buying it on contract.

LUPKIN: A hospital pharmacist who works with Laman, Jeffrey Chow, experienced a drug shortage firsthand earlier this year. When he got a mole biopsied, he learned that the regular numbing injection, lidocaine and epinephrine, wasn't in stock. Without it, Chow bled a lot more, right down his forehead where he could see it.

JEFFREY CHOW: So it was kind of just an eye-opening situation of how much it really can affect customers if they can't get what they need.

LUPKIN: It was a reminder that even though drug shortages happen every day, even minor ones can have a big impact.

Sydney Lupkin, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sydney Lupkin is the pharmaceuticals correspondent for NPR.