| Description |
Drug shortage is a situation that affects the supply of medications, and in turn, affects hospitals, providers, and patients. When drugs are in short supply, patients may face treatment delays, may be unable to find essential drugs, or may face side effects from alternative agents, if alternatives are available. The problem of drug shortage is getting worse because the United States Food and Drug Administration, hospitals, and providers cannot anticipate future shortages. Left with no advanced strategies to face the problem of drug shortages, patient care can be negatively affected. This thesis was intended to answer three questions: 1) do the fluctuations in the number of suppliers prior to drug shortages has any effect on shortages of oncology drugs, 2) are there identifiable trends in number of suppliers and reasons for shortages that can be used to predict future shortages of oncology drugs, and 3) can variation in drug prices relative to shortages based on the number of suppliers in the market at any given time be used as a predictor of shortages? The 41 injectable oncology drugs listed on The American Society of Health- System Pharmacists, the University of Utah Drug Information Service, and Novation web site as in shortage between 2002 and 2010 served as the drugs of interest for this study. After excluding drugs that were available only as brand names as of 2011 (n=12 drugs), and drugs that have been in short supply after 2010 (n=5), information on the remaining iv generic oncology drugs (n=24 drugs) was collected based on characteristics such as drug name, dosage form, route of administration, strength, quantity, price, manufacturer code, supplier name, and number of suppliers. Only 17 products (18 dosage forms) were available for full analysis due to on-going shortages that extended beyond the data collection period. Study findings suggested that the volatility of some drug shortages is not in the number of suppliers prior to shortages; rather it is in the absence of the key manufacturer that is associated with the discontinuation of the brand name. The discontinuation of the brand names of the drugs was associated with a longer shortages period compared to shortages due manufacturing problems or delays. In reality, however five generic injectable manufacturers held the majority of the oncology packages and vials sold in the US market. Efforts should be directed at approving generic products from manufacturers committed to providing stability in the marketplace. Suppliers should have facilities and resources availfor continued production. |
