(Reuters Health)—U.S. emergency rooms are increasingly running short on medications, including many that are needed for life-threatening conditions, a recent study documents.
Since 2008, the number of shortages has risen by more than 400%, researchers found. Half of all emergency room shortages were for life-saving drugs, and for one in 10 there were no available substitutes, they reported online on Dec. 30, 2015, in Academic Emergency Medicine.
Half of the individual shortage incidents had no explanation, the authors found. The rest had a variety of systemic causes that add up to a U.S. drug supply too low to meet public demand.
“Drug shortages are of particular concern in emergency care settings where providers must rapidly treat ill and injured patients,” said lead author Kristy Hawley of the George Washington University School of Medicine and Health Sciences in Washington, D.C. “For most medications, substitutes exist, but may not be as effective and may have more side effects, or providers may not have as much experience with them,” she told Reuters Health by email.
The researchers looked at U.S. data on drug shortages between 2001 and 2014. The information came from hospital doctors’ reports, and it’s possible there were additional unreported shortages, the authors note.
The number of shortages declined steadily between 2001 and 2007, but began a sharp, continual rise in 2008.
Of the 1,798 shortages reported over the 13-year period, 610, or about one third, were for drugs used in emergency medicine. Over half of these were shortages of drugs used as lifesaving interventions or for high-risk conditions.
The average shortage duration for emergency drugs was nine months.
Drugs for treating infections were the most common ones to run low, with 148 shortages. Painkillers and drugs for treating overdoses and poisonings were also among the most common shortages.
Hawley noted that a particularly problematic shortage was for naloxone, the only injectable treatment for opiate overdose.
In nearly half of shortage incidents, the manufacturer did not give a reason for the shortage when contacted. For shortages with a known reason, about a quarter were due to manufacturing problems or delays, around 15% were caused by market supply and demand issues and about 4% were from problems with raw materials.
“Just imagine that a critically ill patient comes to the ER and needs to have specific medication. When we do not have this medication, it can lead to delays in treatment, or it could lead to suboptimal treatment,” said Dr. Ali Pourmand, a professor of emergency medicine at George Washington University who was not involved in the new study.