Drug Shortages and Medication Backorders

Hello again, I hope you are all staying safe and well. In this issue of Ron’s Clinical Corner, I will give an overview of what causes drug shortages.

Drug shortages are nothing new to the prescription drug industry. There are often at least a handful of drugs that are either in short supply or backordered. These can range from products like intravenous fluids in hospitals, to common medications used in the outpatient setting.

Drug shortages happen for multiple reasons which may include: manufacturing delays, supply/demand issues, raw material availability, product discontinuation, or others.

Most recently, during the COVID-19 pandemic, demand for products such as albuterol inhalers outpaced supply and resulted in shortages in some areas of the country.

Raw materials which are often times sourced from other countries, were also affected due to COVID-19. Finally, certain manufacturing facilities were affected by not being able to operate at full capacity. While in these cases COVID-19 was responsible, shortages can also happen due to other reasons.

Typically in the situation where there is a raw material shortage, the unavailability or backorder of medications may be more widespread. The same can be said for if only a few companies manufacture a drug and one either discontinues the product or has a manufacturing issue. For controlled substances, the DEA provides production quotas to manufacturers in an effort to avoid having large amounts of products in the distribution chain. While the quotas are typically adequate, an increase in need could cause a potential shortage or backorder situation.

The specific cause of the shortage and how common the medication is will influence how widespread the impact. As mentioned before, if there is a raw material shortage or an issue with a product only available through a few sources, in theory, the impact could be larger. Another variable in the availability of the drug relates to which pharmacy a patient uses. While most pharmacies work with an internal warehouse or wholesaler, the availability of product is going to depend on the stock within one or both of those places. In addition, the volume of prescriptions the pharmacy fills could also have an impact. This is why during periods of shortages or backorders patients will often check with other pharmacies if their primary pharmacy is unable to supply a medication.

Thanks again for stopping by and see you next month!