Comments on: Drug Shortages http://www.aahpm.org/apps/blog/?p=1645 Physicians caring for patients with serious illness. Thu, 07 Feb 2013 01:31:00 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: Sean Adams, MD http://www.aahpm.org/apps/blog/?p=1645&cpage=1#comment-181950 Sean Adams, MD Tue, 29 Jan 2013 19:45:28 +0000 http://www.aahpm.org/apps/blog/?p=1645#comment-181950 I am a general anesthesiologist, and previously had a practice that included pain management and palliative care. The root cause of pharmaceutical shortages appears to be a dysfunctional supply chain caused by Group Purchasing Organizations. The GAO has looked into this and supports this causation. GPOs have a "Safe Harbor" that exempt them from Antikickback rules, which means the pipeline from manufacturer to our patients doesn't work in any normal way. We need to solve this. I am a general anesthesiologist, and previously had a practice that included pain management and palliative care. The root cause of pharmaceutical shortages appears to be a dysfunctional supply chain caused by Group Purchasing Organizations. The GAO has looked into this and supports this causation.
GPOs have a “Safe Harbor” that exempt them from Antikickback rules, which means the pipeline from manufacturer to our patients doesn’t work in any normal way. We need to solve this.

]]> By: Jenni Levy, MD, FAACH http://www.aahpm.org/apps/blog/?p=1645&cpage=1#comment-176750 Jenni Levy, MD, FAACH Mon, 28 Jan 2013 00:29:05 +0000 http://www.aahpm.org/apps/blog/?p=1645#comment-176750 Last year we had several months when parenteral lorazepam and midazolam were in very short supply. In our inpatient unit, we continued to use lorazepam prn but when we started scheduled doses, we converted to phenobarbital. I hadn't previously used much phenobarb and I found it quite effective - I've continued to use it even though the shortage is resolved. We are not affected by the current issue with parenteral hydromorphone. We find out about shortages from our hospital pharmacy (for the inpatient unit) and from Hospice Pharmacia (for the home hospice program). I'm interested to hear what others are doing. Last year we had several months when parenteral lorazepam and midazolam were in very short supply. In our inpatient unit, we continued to use lorazepam prn but when we started scheduled doses, we converted to phenobarbital. I hadn’t previously used much phenobarb and I found it quite effective – I’ve continued to use it even though the shortage is resolved.

We are not affected by the current issue with parenteral hydromorphone.

We find out about shortages from our hospital pharmacy (for the inpatient unit) and from Hospice Pharmacia (for the home hospice program). I’m interested to hear what others are doing.

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