In recent years, medical patients have had a difficult time securing prescription drugs. Based on the results of an October University study, patients in the University of Michigan Health System haven’t been spared from the challenge of obtaining medication.

University researchers quantified the personnel resources needed to manage drug shortages nationally and defined the impact of drug scarcities on health systems across the country. After surveying 353 pharmacy directors in hospitals across the country, the study concluded that the estimated labor costs associated with managing drug shortages is about $216 million nationally each year.

Burgunda Sweet, director of drug information and investigational drug services at UMHS and one of the authors of the study, said there are additional labor costs because clinicians have to search for drugs that are similar to medication that is inaccessible to their patients.

While drug shortages have been prevalent for the past decade, Sweet said the problem has continued to worsen, especially in the past two years as the number of drugs in short supply has continued to grow.

“The numbers have gone up considerably and the rate of increase continues to be at a pretty steep incline,” Sweet said.

The study found that 80 percent of health systems nationwide reported a shortage of three specific drugs — dextrose syringes, epinephrine injection and succinylcholine injections.

According to the Food and Drug Administration website, there were shortages of 178 drugs in 2010, 132 of which are delivered by sterile injection. Sweet said many of the medications in shortages at UMHS are sterile injections used in routine hospital procedures, such as pain medication, neuromuscular blockers and electrolytes.

Barb Higgins, assistant director of pharmacy services and an author of the study, said drug shortages have also impacted those in the outpatient setting, though to a lesser degree than inpatients, noting that prescription drugs like Adderall have become more expensive and harder to attain.

Higgins added that the University is dealing with shortages of about 40 medications.

While alternative medications for common symptoms like nausea may be easily accessible, Sweet said problems arise when patients can’t find medication for more serious conditions like mineral deficiency. As an example, Sweet explained that the impact of drug shortages can be “considerable” when mineral-deficient patients don’t have access to selenium, which plays a role in the functioning of the thyroid gland.
Sweet said there are many potential reasons for drug shortages—there may be a limited supply of raw materials of a drug, or a manufacturer’s production line may not have passed inspection by the FDA.

“Even if there are backup suppliers, they’re usually not able to supply those quantities, or at the rate that is needed to supply the entire country,” Sweet said. “There are many drugs for which there may be only one manufacturer.”

Sweet said the outlook in the near future for an increase in drug levels looks grim. However, she noted that federal legislation currently being considered may require manufacturers to provide advance notice if a drug will potentially become in shortage in order to better assist patients.

“There’s no one solution that will fix the problem, and so coming at the problem from many different angles, I think is what’s going to have to happen,” Sweet said.

Correction appended: A former version of this article inaccurately stated the yearly labor costs associated with drug shortages.

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