Drug Shortages in Otolaryngology

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Since 2011, annual new drug shortages have fallen from a peak shortage of 267 drugs in 2011 to 185 in 2014; 68 have been reported so far in 2015. Among the common drug classes in short supply from 2010 through 2014, according to statistics gathered by the University of Utah Drug Information Service, are chemotherapy agents, central nervous system (CNS) agents, and antibiotics. Other drug shortages include those used to treat cardiovascular disease, autonomic diseases, gastrointestinal disorders, and eye, ear, nose, and throat conditions, as well as electrolytes and hormones.

The impact of these shortages on the healthcare system and patient care are substantial and include delays in the delivery of medical procedures and drug treatment protocols, higher relapse rates among patients with cancer and other chronic diseases, increased rates of medical errors, and reduced patient health outcomes. In addition, drug shortages may challenge healthcare providers by raising ethical issues about how to distribute drugs in short supply, as well as by requiring them to use alternative therapies that they may not have experience with. Furthermore, patients may choose to purchase needed drugs from other sources, including those found online or in foreign countries.

Further impact on the quality of patient care is seen in the adverse side effects reported after use of alternative therapies when drugs are in short supply. In a 2012 survey by the Institute for Safe Medication Practices (ISMP), pharmacists reported that the medications most commonly involved in adverse effects caused by drug shortages included chemotherapy (particularly doxorubicin), opioid analgesics (mostly fentanyl and morphine), electrolytes, antibiotics, phentolamine, and phytonadione (ISMP. 2012).