Eight in 10 hospitals and pharmacists are rationing drugs or delaying care due to crippling drug shortages – including for cancer

Up to eight in 10 hospitals and pharmacists are rationing medications or postponing appointments as they battle a crippling drug shortage, a report suggests.

A national questionnaire Published Thursday showed there were 309 ongoing drug shortages, the highest number in nearly 10 years. And just a few short of the all-time high of 320.

The American Society of Health-System Pharmacists, a group that tracks drug availability in the U.S., surveyed more than 1,000 pharmacists and 99 percent said they had trouble stocking enough drugs they needed.

The group attributes the problem to limited investment in production capacity, substandard production quality and supply chain failure, as well as extreme price competition among generic drug manufacturers.

The critical shortage is causing 85 percent of pharmacists to ration medications and 42 percent to delay or cancel treatments and procedures, potentially endangering the lives of critically ill patients who will now miss the care they need.

The healthcare professionals surveyed highlighted that the shortages affected patient care, with a third of pharmacists saying the shortages had a critical impact, and more than half, 57 percent, saying they were particularly affected by critical shortages of chemotherapy drugs.

In addition to chemotherapy drugs, other drugs facing limited supplies include hormonal drugs, drugs used in intensive care units and operating rooms, and oral fluids, including the painkiller ibuprofen and the antibiotic amoxicillin.

Others include drugs used to manage attention deficit or hyperactivity and injectable opioids.

After chemotherapy drugs, the shortage that most pharmacists say is causing a critical impact are corticosteroids and hormonal drugs.

Corticosteroids, also called steroids, are anti-inflammatory drugs. Stopping these types of drugs suddenly can cause a person to experience withdrawal symptoms, leading to dizziness, weakness, headaches, mood changes, and pain.

In addition to endangering patient lives, the lack of medicines also costs the healthcare system money.

Managing drug shortages, purchasing alternate doses, and obtaining drugs from alternate sources all cost healthcare facilities more money than if conventional drugs were available.

Pharmacists reported that the shortfalls added between 5 percent and 20 percent to budgets.

The shortages force healthcare providers to make difficult choices, such as delaying a patient’s treatment or changing the dose or type of medication the patient receives.

To address the shortages, most pharmacists, 97 percent, reported changing the medication a patient is receiving to a different, similar medication.

A third of pharmacists said shortages were critical, and more than half, 57 percent, said they were facing critical shortages of chemotherapy drugs in particular

The shortages force healthcare providers to make difficult choices, including delaying a patient’s treatment

Eighty-five percent began rationing medications, and 42 percent said they were forced to cancel or postpone treatments and procedures because they didn’t have access to needed medications.

“Pharmacists have been routinely managing drug shortages for decades, but we are now seeing longer, more persistent shortages. We’re dealing with shortages for over 300 drugs, and that trajectory is growing. This reality is unsustainable for both hospitals and patients.” said ASHP CEO Paul Abramowitz.

“Pharmacists in hospitals and health systems work diligently with other clinicians to provide safe and effective care, despite ongoing drug shortages, by locating needed medications, identifying substitutes, and managing changes to treatment plans as needed.

“In some cases, there are no alternatives to the affected drugs, which puts patients at risk. This issue requires swift action from Congress to address the root causes of shortages and ensure patients get the medicines they need.”

ASHP has called on Congress to better enforce existing laws and implement solutions to reduce disruptions in the drug supply chain, especially for cheaper generics.

The organization has sent several recommendations to Congress to rectify the situation, including calling on them to enforce existing requirements to prevent shortages and impose fines on manufacturers who fail to develop risk management plans.

It also wants Congress to improve manufacturing quality transparency and encourage the establishment of new manufacturers and production sites.