Prescription Drug Shortages: Impact on Neonatal Intensive Care.


Journal

Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577

Informations de publication

Date de publication:
2019
Historique:
received: 30 04 2018
accepted: 22 08 2018
pubmed: 2 11 2018
medline: 18 12 2019
entrez: 2 11 2018
Statut: ppublish

Résumé

Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics. To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs). Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration. Seventy-four of the top 100 NICU drugs were impacted by 227 shortages (10.3% of total shortages). Twenty-eight (12.3%) shortages were unresolved as of December 2016. Resolved shortages had a median duration of 8.8 months (interquartile range 3.6-21.3), and generic drugs were involved in 175 (87.9%). An alternative agent was available for 171 (85.8%) drugs but 120 (70.2%) of alternatives were also affected by shortages. Parenteral drugs were involved in 172 (86.4%) shortages, with longer durations than nonparenteral drugs (9.9 vs. 6.4 months, p = 0.022). The most common shortage reason was manufacturing problems (32.2%). Drug shortages affected many agents used in NICUs, which can have quality and safety implications for patient care, especially in extremely low birth weight infants. Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care.

Sections du résumé

BACKGROUND
Prescription drug shortages have increased significantly during the past two decades and also impact drugs used in critical care and pediatrics.
OBJECTIVES
To analyze drug shortages affecting medications used in neonatal intensive care units (NICUs).
METHODS
Drug shortage data for the top 100 NICU drugs were retrieved from the University of Utah Drug Information Service from 2001 to 2016. Data were analyzed focusing on drug class, formulation, reason for shortage, and shortage duration.
RESULTS
Seventy-four of the top 100 NICU drugs were impacted by 227 shortages (10.3% of total shortages). Twenty-eight (12.3%) shortages were unresolved as of December 2016. Resolved shortages had a median duration of 8.8 months (interquartile range 3.6-21.3), and generic drugs were involved in 175 (87.9%). An alternative agent was available for 171 (85.8%) drugs but 120 (70.2%) of alternatives were also affected by shortages. Parenteral drugs were involved in 172 (86.4%) shortages, with longer durations than nonparenteral drugs (9.9 vs. 6.4 months, p = 0.022). The most common shortage reason was manufacturing problems (32.2%).
CONCLUSIONS
Drug shortages affected many agents used in NICUs, which can have quality and safety implications for patient care, especially in extremely low birth weight infants. Neonatologists must be aware of current shortages and implement mitigation strategies to optimize patient care.

Identifiants

pubmed: 30384374
pii: 000493119
doi: 10.1159/000493119
doi:

Substances chimiques

Drugs, Generic 0
Prescription Drugs 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

108-115

Informations de copyright

© 2018 S. Karger AG, Basel.

Auteurs

Victoria C Ziesenitz (VC)

Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland, ziesenitz.md@gmail.com.
Department of Pediatric Cardiology, University Children's Hospital, Heidelberg, Germany, ziesenitz.md@gmail.com.

Erin Fox (E)

Drug Information Service, University of Utah Health, Salt Lake City, Utah, USA.
College of Pharmacy, University of Utah, Salt Lake City, Utah, USA.

Mark Zocchi (M)

Center for Healthcare Innovation and Policy Research, George Washington University, Washington, District of Columbia, USA.

Samira Samiee-Zafarghandy (S)

Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

Johannes N van den Anker (JN)

Division of Pediatric Pharmacology and Pharmacometrics, University of Basel Children's Hospital, Basel, Switzerland.
Division of Clinical Pharmacology, Children's National Health System, Washington, District of Columbia, USA.

Maryann Mazer-Amirshahi (M)

Department of Emergency Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Georgetown University School of Medicine, Washington, District of Columbia, USA.

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Classifications MeSH