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Editorial: Trends in Drug Shortages; Opportunities for Compounding, Part 1
In a recent publication (Am J Health-Syst Pharm 2009; 66: 798-800), the University of Utah Drug Information Service (DIS) reported on their experiences related to drug shortages. Back in 2001, the DIS began tracking drug shortages and monitored 120 drug shortages that year. Over the next few years, there was a decline in the number of shortages until 2005 when the numbers began increasing. Data for 2008 shows they monitored 150 drug shortages. The median duration of shortages has declined from about 130 to 137 days in 2003, 2005, and 2006; to about 91 days in 2004; and 50 days in 2007.
The most common type of drug in short supply is a generic injection. The authors state this may be due to consolidation in the industry and fewer companies making generic injectables resulting in few products with multiple suppliers. Reasons for the shortage include manufacturing problems, regulatory issues, as well as supply and demand issues.
Examples of injectable drugs that have frequently been in short supply include hydralazine, meropenem, multiple vitamins, nafcillin, pantoprazole, piperacillin-tazobactam, protamine, rabies immune globulin, and thiamine.
Oftentimes, compounding pharmacies step up and provide medications in short supply so patients' therapies can proceed uninterrupted. With 150 drug shortages in 2008 and about 2 to 3 months duration on average, this is an opportunity for compounding pharmacists.
Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
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Drug Substances in U.S. Waterways
The U.S. pharmaceutical industry and other manufacturers have legally released at least 271 million pounds of pharmaceuticals into waterways that often provide drinking water, according to an Associated Press investigation. There are actually hundreds of different pharmaceutical ingredients that are used in a variety of manufacturing processes, including lithium (used to make ceramics and treat bipolar disorder), nitroglycerin (a heart drug also used in explosives), and copper (in everything from pipes to contraceptives).
http://www.usnews.com/articles/science/2009/04/19/tons-of-released-drugs-taint-us-water.html
States Consider Cutting Financing of Drug Help for Seniors
The financial crisis related to Medicare Part D insurance plan has grown so severe that lawmakers in Rhode Island and five other states have debated whether to cut or reduce the state funding that helps seniors and disabled people buy their drugs.
One patient in Rhode Island, who lives off about $10,000 a year, worries she may need to stop taking her arthritis medication to make ends meet. She stocks shelves and helps distribute food as a volunteer at a Salvation Army food shelter.
Her predicament is shared by many of the nearly 27 million people enrolled nationally in Medicare Part D, the federal insurance plan that covers prescription drugs for seniors until the total bill reaches $2,700. At that point, seniors hit what's commonly called the "doughnut hole," and must personally pay the drug bill until their out-of-pocket costs reach $4,350, at which point Medicare coverage resumes. Sixteen states offer financial assistance when seniors hit this level. Other states offer some help to defray some of the premium costs associated with Medicare.
Eliminating the program in Rhode Island would save about $700,000 and affect around 8,000 people, while a proposal to scale back benefits in South Carolina would have trimmed roughly $7 million. Officials in South Carolina have estimated about 22,000 people are eligible for the program. Those savings aren't huge; they amount to less than 1 percent of the total budget in both states.
http://www.google.com
Automatic Dispensing Units Tested in Vermont
An automatic dispensing unit (ADU) for prescriptions is now being used in rural Vermont. As part of a pilot project in Plainfield, Vermont, the Health Center is home to an automated cabinet where the pharmacist holds patients' prescriptions from five different health centers. A summary of the system includes the following; (1) the automated system can hold up to 122 filled prescriptions at a time, (2) the unit is operated by a registered pharmacy tech who is supervised by live video feed, (3) the centralized location ensures that necessary medications will be immediately available to patients living in remote areas, (4) prescriptions are mailed to patients who cannot travel to Plainfield to pick them up, (5) patients appreciate the savings in travel, waiting time, and mileage costs, and (6) if patients wish to speak with a pharmacist, they can do so by video phone.
The federally-funded Community Health Center network, made up of five clinics throughout Vermont, is testing the automated "intelePharmacy" from PickPoint, in Pleasanton, California. The ADU is a seven-foot-tall bulletproof cabinet that can hold up to 122 prescriptions. The ADU assists pharmacists and pharmacy technicians as they fill prescriptions in one location for patients from the spread-out clinics, essentially acting as a telepharmacy, according to Jennifer Browe, the pharmacist in charge for the Community Health Center network. The medications are stored in a locked machine similar to a vending machine. Only a pharmacist has access to release medications from the ADU. A registered pharmacy technician runs the remote pharmacy while being observed over a live video feed.
http://drugtopics.modernmedicine.com
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