WTAE Listens: Drug shortages impacting patients

WTAE Listens: Drug shortages impacting patients

Updated: 11:30 AM EDT Aug 6, 2023

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GOOD MORNING AND WELCOME TO WTAE LISTENS. I’M ANDREW STOCKEY. TODAY WE’RE TALKING ABOUT DRUG SHORTAGES FROM HOSPITALS TO PHARMACY SHELVES. THE ISSUE IS IMPACTING PATIENTS ACROSS THE UNITED STATES. THIS MORNING, WE’RE LEARNING HOW THE MEDICAL FIELD IS RISING TO THE CHALLENGE. AMOXIL CILLIN AND IBUPROFEN, ADDERALL AND CANCER DRUGS. SEVERAL CRUCIAL MEDICATIONS HAVE BEEN HARD TO FIND LATELY. SHORTAGES ARE DEFINITELY HAVING AN IMPACT ON PATIENT CARE. DOCTORS DEALING WITH THE ISSUE FROM COAST TO COAST, BUT THE PROBLEM ISN’T NECESSARILY NEW. IN 2011, THE NUMBER OF NEW DRUG SHORTAGES HIT A HIGH OF 250. LAST YEAR, THAT NUMBER WAS JUST 49 AND NEW SHORTAGES HAVE HOVERED AROUND THERE THE PAST FEW YEARS. BUT EACH YEAR BRINGS UNIQUE OBSTACLES. FOR INSTANCE, THE TORNADO THAT TORE THROUGH A PFIZER PLANT IN NORTH CAROLINA LAST MONTH, OR THE FDA’S SUDDEN CLOSURE OF A PHARMACEUTICAL PLANT IN INDIA FOLLOWING AN INSPECTION, WE KNEW THAT A PLANT WENT DOWN. WE DID NOT KNOW HOW MUCH IT IMPACTED ALL THE MANUFACTURERS. IT JUST SHOWS HOW FACTORS DRIVING SHORTAGES CAN COME OUT OF NOWHERE. THEY’RE NOT ONLY INCREASING IN FREQUENCY, BUT ALSO SHOW DURATION. THIS MORNING, A PROFESSOR EXPLAINS THE SITUATION WE FACED NATIONWIDE AND HERE IN PITTSBURGH. IT’S QUITE SERIOUS. AND YET WE’VE BEEN ABLE TO MITIGATE, REDUCE THE PROBLEMS THAT WE’VE HAD. PRESCRIBERS, PERSPECTIVE OF HOW DOCTORS ARE STILL MANAGING TO MEET THEIR PATIENTS NEEDS AND NATIONALLY THERE IS A MAJOR STRUGGLE TO MAKE SURE THAT WE CAN FIND DRUG FOR OUR PATIENTS. TACKLING A WIDESPREAD ISSUE WITH TEAMWORK, THE STRATEGIES BEING EMPLOYED BY PHARMACISTS EVERYWHERE. WHAT IS CAUSING THE DRUG SHORTAGES THAT WE’RE SEEING AND WHAT MEDICINES ARE BEING IMPACTED THE MOST? WELL, WE TOOK THOSE QUESTIONS TO A LOCAL PROFESSOR OF MEDICINE TO FIND OUT. I’M JOINED NOW BY DR. KATIE SUDA, PROFESSOR OF MEDICINE AT THE UNIVERSITY OF PITTSBURGH. I UNDERSTAND YOU ARE ALSO WORKING ON A STUDY RIGHT NOW FUNDED BY THE GOVERNMENT ON THIS VERY TOPIC OF DRUG SHORTAGES. NOW, BEFORE WE GET INTO THAT DISCUSSION, I WANT TO ASK YOU ABOUT YOUR SPECIALTY. I UNDERSTAND YOU. AND LET ME SEE IF I CAN PRONOUNCE THIS CORRECTLY, PHARMACOEPIDEMIOLOGY IS YOUR SPECIALTY. WHAT IS THAT? PHARMACOEPIDEMIOLOGY IS WHERE WE USE LARGE DATA SETS OF MEDICATIONS THAT WERE PRESCRIBED BY CLINICIANS AND USED BY PATIENTS. AND WE LOOK AT THE ASSOCIATION NATION OF MEDICATION USE AND OUTCOMES OF OUR PATIENTS, BOTH POSITIVE, IMPROVING DISEASES AS WELL AS NOT SO GOOD OUTCOMES LIKE CAUSING ADVERSE DRUG EVENTS. ALL RIGHT. LET’S GET TO THE TOPIC AT HAND NOW. DRUG SHORTAGES PAINT A BROAD PICTURE FOR US. HOW SERIOUS IS THE PROBLEM RIGHT NOW IN THE UNITED STATES? DRUG SHORTAGES ARE A SIGNIFICANT PROBLEM, AND THEY’RE NOT ONLY INCREASING IN FREQUENCY C, BUT ALSO DURATION IN. SO THE AMOUNT OF TIME A MEDICINE IS ON SHORTAGE AS WELL AS SEVERITY OR THE IMPACT THAT THAT A SHORTAGE HAS ON THE LITTLE BIT OF MEDICINE WE HAVE LEFT ON OUR ON OUR PHARMACY SHELVES. BUT DRUG SHORTAGES HAVE BEEN A PROBLEM FOR DECADES. BUT IN THE PAST, DRUG SHORTAGES PRIMARILY IMPACTED MEDICINES THAT WE ADMINISTERED IN THE HOSPITAL OR IN LONG TERM CARE FACILITIES SUCH AS INTRAVENOUS MEDICINES. BUT SHORTAGES ARE INCREASING FOR ORAL MEDICINES. SO THOSE MEDICINES THAT YOU AND I MAY TAKE EVERY DAY AND MEDICINES THAT DON’T HAVE ANY OTHER ALTERNATES AVAILABLE. LET’S TALK ABOUT THOSE MEDICINES IN PARTICULAR. WHEN YOU TALK ABOUT ORAL MEDICINES, WHAT ARE WE TALKING ABOUT HERE? SO RECENTLY THERE HAS BEEN A SHORTAGE OF ORAL AMOXICILLIN, WHICH IS AN ANTIBIOTIC THAT’S FREQUENTLY ADMINISTERED TO CHILDREN FOR THINGS LIKE RESPIRATORY TRACT INFECTIONS OR EAR INFECTIONS. ADULTS ALSO TAKE THE CAPSULE FORMULATION OF THAT MEDICINE FOR THINGS LIKE PNEUMONIA OR EVEN URINARY TRACT INFECTIONS. AND THE PROBLEM THERE WAS THAT THERE WAS A SURGE IN DEMAND OF AMOXICILLIN, SPECIFICALLY THE ORAL SUSPENSION OR THE LIQUID FORMULATION THAT KIDS TEND TO TAKE. BUT THERE’S BEEN OTHER SHORTAGES AS WELL. SO RIGHT NOW THERE IS EVEN SOME MOVEMENT WITHIN CONGRESS TO RESOLVE THE CISPLATIN SHORTAGE. SO CISPLATIN IS A CHEMOTHERAPEUTIC MEDICINE USED FOR PATIENTS WITH CANCER. AND THERE’S FEW ALTERNATE MEDICINES AVAILABLE FOR CISPLATIN. YOU ALSO MENTIONED MEDICINES ARE AVAILABLE IN HOSPITALS. WHICH ONES ARE WE TALKING ABOUT HERE? THE MEDICINES USED IN HOSPITALS THAT HAVE FREQUENTLY BEEN ON SHORTAGE ARE MEDICINES THAT WE USE IN CRITICAL CARE SETTINGS. SO IN THE ICU THAT KEEP PATIENTS MAYBE UNDER SEDATION SO THEY KEEP THEM ASLEEP, THEY KEEP THEM FROM MOVING SO WE CAN PUT THEM ON A BREATHING MACHINE. WE ALSO HAVE FREQUENTLY SEEN SHORTAGES OF IV CORTICOSTEROIDS THAT ARE USED FOR ALL DIFFERENT KINDS OF DISEASE STATES AND THEN ALSO ONE OF THE TOP CLASSES THAT WE SEE, DRUG SHORTAGES WHICH HAVE BEEN OCCURRING FOR DECADES, ARE ANTIBIOTICS, ESPECIALLY IV ANTIBIOTICS. AND DRUG MANUFACTURERS ARE NOT REALLY IN THE GAME ANYMORE TO PRODUCE ANTIBIOTICS. SO THERE’S FEWER AND FEWER ANTIBIOTICS AVAILABLE THAT WE CAN PRESCRIBE FOR PATIENTS. AND WITH MULTIDRUG RESISTANCE INCREASING AS WELL AS THINGS LIKE WE’VE RECENTLY SEEN WITH THE COVID 19 PANDEMIC, IT’S MORE AND MORE IMPORTANT THAT WE HAVE ANTI MICROBIALS AVAILABLE AT OUR DISPOSAL TO GIVE OUR PATIENTS. OKAY. THIS MAY SOUND LIKE A SIMPLE QUESTION, BUT WHAT’S THE WORST CASE SCENARIO HERE? IF THIS CONTINUES, WE WON’T HAVE MEDICINES TO GIVE TO OUR PATIENTS OR MAYBE NOT THE MOST EFFECTIVE MEDICINES. SO THERE’S CERTAIN MEDICINES THAT WE LIKE THAT WE CONSIDER TO BE FIRST LINE. SO THOSE MEDICINES THAT ARE SAFEST AND THE MOST EFFECTIVE. SO WE HAVE TO GO DOWN THE LINE TO SECOND. SECOND LINE MEDICINES, THIRD LINE MEDICINES. AND THOSE MEDICINES MAY HAVE A HIGHER FREQUENCY OF ADVERSE EVENTS. OR WHILE THEY MAY WORK FOR YOU, THEY MAY NOT WORK AS WELL. FOR ME, FOR EXAMPLE. NOW, YOUR STUDY IS STILL IN PROGRESS, BUT FROM WHAT YOU’VE SEEN SO FAR, WHY ARE WE EXPERIENCING THIS RIGHT NOW? WHAT’S GOING ON HERE? SO FROM MY WORK AS WELL AS WORK THAT OTHERS HAVE DONE, SOME OF THE CAUSES, THESE ARE MANUFACTURING ISSUES SUCH AS QUALITY PROBLEMS. SO SUCH AS STERILITY, HAVING A STERILE PRODUCT FOR IV MEDICINES, MANUFACTURING PROBLEMS SUCH AS NOT BEING ABLE TO GET THE RAW MATERIAL OILS THAT ARE THEN COMBINED TO INTO A TABLET OR A CAPSULE. WHAT YOU SEE WHEN YOU OPEN YOUR MEDICINE BOTTLE, OTHER THINGS ARE BUSINESS PROBLEMS, SUCH AS A MANUFACTURER DECLARES BANKRUPTCY OR MAKES A DECISION TO NO LONGER MAKE A MEDICINE BECAUSE IT’S NOT PROFITABLE. THERE’S ALSO UNANTICIPATED EVENTS SUCH AS SOCIAL OR POLITICAL UPHEAVAL. WAR IS A IS A EXAMPLE OF THOSE EVENTS. OTHER EVENTS INCLUDE EPIDEMICS OR PANDEMICS AND EXTREME WEATHER EVENTS SUCH AS HURRICANES. WE ALSO SEE THAT FOR SOME MEDICINES SUCH AS GENERIC MEDICINES, THERE’S MULTIPLE MANUFACTURE ERRORS OF THAT GENERIC MEDICINE, AND IT’S NO LONGER PROFITABLE TO MAKE THAT MEDICINE BECAUSE WE HAVE DRIVEN THE PRICE OF GENERIC MEDICINE SO LOW. DR. SUDHA, LET’S TALK ABOUT PITTSBURGH FOR A MOMENT. IS THE SITUATION WORSE HERE THAN IN OTHER PLACES? IS IT BETTER AND IS THERE A ROLE THAT PITTSBURGH CAN PLAY IN TERMS OF FILLING THESE SHORTAGES AND MANUFACTURING DRUGS? TYPICALLY, IF THERE’S A SHORTAGE IN PITTSBURGH, IT WILL BE A SHORTAGE NATIONALLY. SO THERE’S REALLY NO DIFFERENCE WITHIN OUR COMMUNITY VERSUS WHAT YOU MIGHT SEE ON THE WEST COAST OR THE EAST COAST. AND YES, I DO BELIEVE THAT THERE COULD BE AN OPPORTUNITY DOUGHERTY HERE IN PITTSBURGH TO PRODUCE MEDICINES FIRST. BUT WE’RE SOMEWHAT INSULATED FROM EXTREME WEATHER EVENTS THAT WE’RE ONLY SEEING INCREASE WITH CLIMATE CHANGE, SUCH AS SEVERE FLOODING AND HURRICANES. WE DON’T REALLY HAVE THAT HERE. WE ALSO HAVE A STRONG MANUFACTURING INFRASTRUCTURE AND HISTORY AND OF WORKFORCE THAT KNOWS HOW TO MANUFACTURE A PRODUCT. AND WE CAN ALSO ADD SOME EXPERTISE TO THAT WITH THE STRONG HEALTH SCIENCES AT THE UNIVERSITY OF PITTSBURGH, AS WELL AS THE STRONG TECHNOLOGY, ENGINEERING AND ROBOTICS AT PITT, AS WELL AS CARNEGIE MELLON UNIVERSITY. AND ONE THING THAT IS ALSO VERY IMPORTANT WHEN YOU THINK ABOUT DRUG MANUFACTURING IS TRANSPORTATION. AND NOT ONLY CAN WE TRANSPORT PRODUCT VERSUS ON THE ROAD AND IN THE AIR, WE ALSO HAVE A STRONG RAIL SYSTEM HERE AS WELL AS A FRESH WATER SYSTEM WITH BARGES GOING THROUGH. AND FRESH WATER, OF COURSE, IS ALSO IMPORTANT WHEN YOU THINK OF DRUG MANUFACTURING. SO WHILE WE MAY BE ABLE TO PRODUCE SOME MEDICINES, ESPECIALLY THOSE MEDICINES THAT ARE AT THE HIGHEST RISK OF A SHORTAGE, WE STILL, THOUGH, WILL PROBABLY RELY ON OTHER COUNTRIES TO PRODUCE OUR MEDICINES. STILL AHEAD, YOU NEVER WANT TO BE IN THIS SITUATION AS A PHYSICIAN SAYING WHO’S MORE IMPORTANT, MAKING SURE EVERY PATIENT GETS THE MEDICATION THEY NEED. HOW DOCTORS ARE OVERCOMING SHORTAGES TO DELIVER CRUCIAL CARE. WELCOME BACK TO WTAE LISTENS. WE TURN OUR ATTENTION NOW TO THE SHORTAGE OF CANCER DRUGS. WE SAT DOWN WITH A DOCTOR DEALING WITH THIS REALITY EVERY DAY. WE ARE JOINED NOW BY DOCTOR NATHAN BARI, THE DIVISION CHIEF OF MEDICAL ONCOLOGY AT THE ALLEGHENY HEALTH NETWORK CANCER INSTITUTE. WE THANK YOU FOR JOINING US FOR THIS CONVERSATION. THANK YOU FOR INVITING US. IT’S REALLY WONDERFUL. YOU’RE WELCOME. OKAY. FOR THOSE OF US WHO LIVE HERE IN WESTERN PENNSYLVANIA, YOU AS A DOCTOR WORKING IN A HOSPITAL, HOW SERIOUS IS THIS ISSUE OF DRUG SHORTAGES? IT’S QUITE SERIOUS. AND YET WE’VE BEEN ABLE TO MITIGATE IT, REDUCE THE PROBLEMS THAT WE’VE HAD BY BY SEEING SOME OF THIS COMING AHEAD. AND, YOU KNOW, SO IT DEPENDS UPON THE DRUG AND THE TIME. SO, YOU KNOW, A MONTH AGO, OUR CENTER WAS REALLY SHORT ON A DRUG CALLED CISPLATIN, WHICH IS REALLY IMPORTANT. AND THAT’S BEEN ALLEVIATED AS OTHER SUPPLY CHAINS HAVE BEEN OPENED UP. ON THE OTHER HAND, ANOTHER DRUG, CARBOPLATIN, WHICH WE ALSO USE QUITE A BIT OF, IS BECOMING SOMEWHAT OF MORE OF AN ISSUE. AND WE’RE BEGINNING TO HAVE TO LOOK AT HOW TO MITIGATE THAT. SO IT’S AN IMPORTANT ISSUE TOO. BUT I JUST WANT TO LET PEOPLE KNOW THAT WE’VE BEEN ABLE TO FIND ALTERNATIVES FOR MOST OF THIS BEFORE WE GO INTO THOSE ALTERNATIVE WAYS. YOU MENTIONED SOME OF THOSE DRUGS, BUT THE BIG ONES WHERE THERE REALLY IS A SHORTAGE, RIGHT, MAYBE A CRITICAL SHORTAGE AT THIS POINT. I’M GOING TO BE IT DEPENDS UPON THE SYSTEM THAT YOU’RE IN, WHICH IS WHY IT’S ALWAYS REALLY IMPORTANT TO TALK TO YOUR PHYSICIANS, BECAUSE SOME HOSPITALS ARE SHORT OR SHORTAGE OF SOME DRUGS THAT OTHERS MAY NOT BE BECAUSE THEY HAVE DIFFERENT SUPPLIERS. WE HAD A FAIRLY CRITICAL SHORTAGE OF CISPLATIN, BUT THAT’S BEEN ALLEVIATED RECENTLY. WE’RE DOING PRETTY WELL WITH THAT. AND WE ACTUALLY HAD TO WE WERE ABLE TO REMOVE ALL THE CURBS ON THAT FOR HOW WE WERE GOING TO USE IT. ANOTHER DRUG IS CALLED CARBOPLATIN. WE HAD SOME ISSUES WITH THAT AND WE’RE BEGINNING TO TRY TO FIGURE OUT HOW TO GET A LITTLE BIT MORE OF IT. BUT WE HAVEN’T HAD TO WITHHOLD IT FROM ANYBODY, WHICH IS WHAT’S REALLY IMPORTANT. ANOTHER DRUG IS AN INFUSION DRUG CALLED FIVE FLUOROURACIL. THAT’S USED IN QUITE A NUMBER OF PATIENTS WITH GI CANCERS, COLON CANCERS, BREAST CANCERS. AND THEN IF YOU LOOK ON THE HEMATOLOGIC SIDE IN TERMS OF CHEMOTHERAPY, THERE’S A DRUG CALLED FLUDARABINE, WHICH IS OFTEN USED IN BONE MARROW TRANSPLANTS, WHICH HAS ALSO PROVEN DIFFICULT TO SOMETIMES FIND FOR PATIENTS. SO BUT AGAIN, ALTERNATIVES EXIST. WHAT’S IMPORTANT TO REALIZE IS THAT THESE COME AND GO AND THERE’S HUNDREDS OF THEM, QUITE LITERALLY HUNDREDS OF DRUGS OVERALL THAT ARE IN SHORT SUPPLY, YOU KNOW, AT LEAST ON THE FDA WEBSITE, IF YOU TAKE A LOOK OR SO AND SO THIS HAS BEEN SOMETHING THAT’S BEEN COOKING FOR A WHILE, AND IT’S REALLY COME HOME TO ROOST, I THINK. WELL, IF YOU DON’T HAVE SOME OF THOSE PRIMARY DRUGS IN VERY SHORT SUPPLY, WHAT ARE THE ALTERNATIVES? DO YOU GO TO A SECOND DRUG? AND IF THAT’S THE CASE, WHAT ARE SOME OF THE ISSUES IN USING A SECONDARY DRUG? RIGHT. SO SOME OF THE DRUGS HAVE BEEN TESTED ONLY IN CERTAIN SITUATIONS. US SO IT MIGHT BE, FOR INSTANCE, IN CERTAIN CANCERS YOU’VE USED DRUG A AND IT’S BEEN TESTED WHEN PEOPLE FIRST PRESENT AND WE KNOW THAT IT’S HELPFUL. SO NOW WE CAN SUBSTITUTE A DRUG. WE THINK IT’S THE SAME. RIGHT? THERE HAVE BEEN SMALLER STUDIES THAT HAVE LOOKED AT IT, BUT IT DOESN’T CARRY FDA APPROVAL FOR THAT. WE THINK WE’RE OKAY. WE DON’T THINK WE’VE HARMED ANYBODY, BUT WE ALWAYS TRY NOT TO HAVE TO MAKE THOSE DECISIONS IF WE CAN. AND SOMETIMES THERE’S JUST A WAY PEOPLE PRACTICE THIS. AND SO PEOPLE ARE USED TO USING CERTAIN DRUGS AND CERTAIN TIMES, BUT YOU DON’T NECESSARILY HAVE TO. SO IF WE SAY INSTEAD OF USING IT NOW, CAN YOU USE IT A LITTLE BIT LATER AND YOU CAN SAVE IT FOR THE PEOPLE WHO REALLY DO NEED IT? BECAUSE, FOR INSTANCE, WHEN CISPLATIN WAS WAS VERY SHORT IN SOME PLACES IN THE COUNTRY, IT STILL IS EVEN IT’S BEEN ALLEVIATED AT AN THE ISSUE IS THAT THAT DRUG HAS BEEN PROVEN TO BE CRITICAL IN PATIENTS WITH CERTAIN TYPES OF CANCERS, CERTAIN LUNG CANCERS AND BREAST CANCERS, CERTAIN OVARIAN CANCERS AND GERM CELL TUMORS, TESTICULAR TUMORS AND STUFF. AND SO, YOU KNOW, YOU NEVER WANT TO BE IN THIS SITUATION AS A PHYSICIAN SAYING WHO’S MORE IMPORTANT? THE 19 YEAR OLD GIRL WHO’S GOT A BONE TUMOR AND OSTEOSARCOMA, THE 27 YEAR OLD GENTLEMAN WITH A TESTICULAR TUMOR, OR THE 60 YEAR OLD PERSON WITH LUNG CANCER. RIGHT. I DON’T WANT TO WAKE UP. THAT’S MY FEAR, IS WAKING UP IN THE MORNING AND HAVING TO MAKE THAT KIND OF DECISION. AND WE HAVEN’T HAD TO, YOU KNOW, SO FAR. AND LET’S HOPE YOU DON’T. YOU NEVER HAVE TO DO THAT. THAT’S ABSOLUTELY RIGHT. BUT IN THIS SITUATION, IS THE ANSWER TO THESE SHORTAGES, IS IT HERE IN WESTERN PENNSYLVANIA, DO WE HAVE PERHAPS THE TECHNOLOGY, THE THE KNOWLEDGE, THE SUPPLY TO MAYBE REPLENISH THESE THESE DRUGS THAT ARE MISSING? WELL, CERTAIN THINGS ARE, YOU KNOW, CERTAINLY OUR PHARMACY HAS BEEN RATHER AMAZING IN FINDING OUT ALTERNATIVE WAYS. I’M SORT OF HIJACKING THE TRUCK THAT BRINGING IT TO SOMEBODY ELSE AND FINDING ALTERNATIVE SUPPLIERS AND KNOWING IT AHEAD OF TIME TO TRY TO BUILD UP A LITTLE BIT OF A STOCK. BUT WHAT THE REAL BIG PROBLEM IS, IS A LOT OF THESE DRUGS ARE GENERIC AND PHARMACEUTIC COMPANIES DON’T MAKE A LOT OF MONEY OFF OF THEM. AND SO THEY’VE BEEN SHIFTED OVERSEAS. AND SO A CISPLATIN, FOR INSTANCE, THERE WAS ONE COMPANY PRIMARILY IN INDIA THAT THE FDA SHUT DOWN BECAUSE THERE WERE PRODUCTION PROBLEMS. I MEAN, IT COULD HAVE BEEN HARMFUL. THERE WERE YOU KNOW, THEY DIDN’T KEEP STERILE CONDITIONS PROPERLY. AND SO THE PROBLEM THAT WE HAVE IS THAT THERE IS NOT AN ALTERNATIVE SUPPLIER. IN THAT CASE, THERE WAS ONE IN CHINA. THEY ALLOWED US TO IMPORT IT THROUGH CANADA TO THE UNITED STATES. AND THEY ALLOWED BUT PART OF THE ISSUE THAT PEOPLE SHOULD KNOW IS THAT, YOU KNOW, WE’VE SORT OF PUT OURSELVES AT A DISADVANTAGE. YOU KNOW, THERE’S SO MANY THINGS THAT WE DO AND WE SUPPORT AND AND I WOULD SAY AS A PHYSICIAN, I HOPE THAT WE CAN SUPPORT TRYING TO BRING BACK TO THE UNITED STATES SOME PRODUCTION OF THESE DRUGS. I DON’T KNOW HOW YOU DO THAT FINANCIALLY. I’M NOT IN CONGRESS. BUT, YOU KNOW, THERE’S ALL SORTS OF WAYS OF DOING THIS, AS MY UNDERSTANDING. AND I’D LOVE TO SEE SOMETHING TO BE DONE SO THAT WE CAN ONCE AGAIN PRODUCE THESE HERE AT THE HIGHER STANDARDS THAT THE FDA WANTS. STILL TO COME, IT IS THE ONE OF THE BIGGEST DRUG SHORTAGES THAT HAS HAD THE MOST IMPACT ON OUR PATIENTS IN RECENT HISTORY AND HISTORIC SHORTAGE. HOW THE PHARMACEUTICAL INDUSTRY IS MOVING DRUGS TO WHERE THEY ARE NEEDED THE MOST. WELCOME BACK TO WTAE. LESSONS WITH CERTAIN CANCER DRUGS IN SHORT SUPPLY. PHARMACISTS ARE BEING STRATEGIC. TO GET THE PRODUCTS THEY NEED. WE SPOKE TO A CLINICAL PHARMACY SPECIALIST ABOUT WHAT THAT ENTAILS. WE’RE JOINED NOW BY DANIEL ROMAN. WE THANK HER FOR JOINING US. SHE IS AN ONCOLOGY CLINICAL PHARMACY. SPECIALIST AT ALLEGHENY HEALTH NETWORK. ONCE AGAIN, THANK YOU SO MUCH FOR JOINING US. THANKS FOR HAVING ME. SO YOU TALK WITH OTHERS IN THE PHARMACEUTICAL FIELD, THE PHARMACY FIELD. WHAT ARE THEY SAYING ABOUT THESE SHORTAGES THAT WE’RE HEARING SO MUCH ABOUT RECENTLY? SO I KNOW NATIONALLY THERE IS A MAJOR STRUGGLE. TO MAKE SURE THAT WE CAN FIND DRUG FOR OUR PATIENTS, PARTICULARLY WITH CISPLATIN AND CARBOPLATIN. AMONG SOME OTHER AGENTS THAT ARE IN CRITICAL SHORTAGE, IT IS THE ONE OF THE BIGGEST DRUG SHORTAGES THAT HAS HAD THE MOST IMPACT ON OUR PATIENTS IN RECENT HISTORY. AND SO WORKING NATIONALLY TO FIND SOME SOLUTIONS. BUT WE’RE ALL EXPERIENCING THESE CHALLENGES NOW. I UNDERSTAND THIS IS NOT A SURPRISE, MAYBE A SURPRISE TO US, BUT NOT TO YOU AND THE PEOPLE IN YOUR FIELD. IN FACT, YOU KNEW THIS WAS COMING AND YOU’VE BEEN PREPARING FOR THIS TO SOME DEGREE. YES. SO WE DON’T OFTEN HAVE A WHOLE LOT OF NOTICE THAT THIS IS HAPPENING. BUT WHEN THINGS HAPPEN AND IN THIS PARTICULAR SITUATION WITH A COMPANY IN INDIA THAT SHUT DOWN MANUFACTURE OF THE PRODUCT THROUGH THE FDA, WE DID HAVE A LITTLE BIT OF NOTICE THAT ALLOWED FOR SOME PREPARATION. BUT OFTENTIMES WE ARE STILL A LOT OF US ARE STILL KIND OF SCRAMBLING LAST MINUTE TO TRY TO FIGURE OUT SOLUTIONS. WELL, WHAT ARE THE SOLUTIONS HERE? I MEAN, IF A DRUG IS NOT AVAILABLE OR IT’S IN LIMITED SUPPLY, WHAT CAN YOU DO TO REPLACE THAT DRUG? SO THE FIRST PART IS JUST WORKING INTERNALLY TO TRY TO MAXIMIZE THE ABILITY TO MOVE DRUG AROUND. SO WE HAVE A LOT OF DIFFERENT FACILITIES WHERE WE HOUSE THESE AGENTS. SO REALLY BEING ABLE TO MOVE DRUG AROUND TO MINIMIZE THE IMPACT AT PARTICULAR AREAS MAYBE WHERE WE HAVE A LITTLE BIT OF EXCESS AT A CERTAIN MOMENT WHERE WE CAN MOVE THAT AROUND TO A PLACE THAT IS IN NEED OF THE AGENT. SO REALLY JUST WORKING INTERNALLY TO TRY TO MOVE PRODUCT AROUND AND TO MINIMIZE IMPACT AND ALSO WORKING ON THE LEVEL WE MAY NOT BE ABLE TO GET IT FROM OUR TYPICAL DISTRIBUTOR HERE, BUT THERE ARE SOME AVENUES SOMETIMES WORKING DIRECTLY WITH SOME COMPANIES TO TRY THE DRUG COMPANIES TO TRY TO HAVE SOME ADDITIONAL SOURCES OF DRUG COMING IN. AND YOU ALSO TOLD ME THE RELATIONSHIP WITHIN HHN WITH THE DOCTORS AND THE PHARMACISTS HAS HELPED TO MAYBE NOT ALLEVIATE THE PROBLEM, BUT MAYBE FIND OTHER SOLUTIONS TO THIS ISSUE. YEAH. SO WE HAVE A LOT OF PROBLEM SOLVERS MEETING TOGETHER TO TRY TO TRY TO FIGURE OUT NEXT STEPS FORWARD. SO LUCKY, LUCKY TO HAVE A LOT OF GREAT COLLABORATION BETWEEN OUR PHARMACY GROUP AS WELL AS OUR PHYSICIAN GROUP TO REALLY TALK ABOUT ON A REGULAR BASIS WHERE WE STAND WITH OUR SUPPLY, WHAT STEPS WE NEED TO TAKE TO TRY TO MITIGATE THAT. SO WHAT IS THE ANSWER TO ALL THIS? I MEAN, HOW DO WE SOLVE THIS PROBLEM? WHERE YOU DON’T HAVE A CERTAIN DRUG OR NOT ENOUGH OF IT? WHAT CAN BE DONE AND CAN THE ANSWER BE FOUND RIGHT HERE IN WESTERN PENNSYLVANIA? YEAH. SO YOU’RE ASKING A REALLY DIFFICULT QUESTION. I WOULD SAY IT IS NOT AN EASY SOLUTION TO THIS. THERE ARE MANY FACTORS ON A NATIONAL LEVEL THAT ARE IMPACTING WHAT WE’RE SEEING RIGHT NOW. SO I THINK A LOT OF CHANGE NEEDS TO HAPPEN ON A NATIONAL LEVEL TO TRY TO BRING ADDITIONAL GENERIC MANUFACTURERS INTO THE MARKET HERE TO TRY TO MEET A LOT OF THE DEMAND ISSUES THAT WE’RE SEEING. I THINK IN TERMS OF WHAT CAN HAPPEN IN WESTERN PENNSYLVANIA TO UNFORTUNATELY VERY LITTLE. BUT I CAN SAY THAT WE’RE WORKING TOGETHER WITHIN THE REGION AS A AS A PHARMACY TEAM WITHIN PENN AND ELSEWHERE TO TRY TO PROBLEM SOLVE AND FIGURE OUT HOW WE CAN MEET THE NEEDS OF OUR PATIENTS. AND TRYING TO ALSO KEEP IN TOUCH WITH THOUGHT LEADERS NATIONALLY TO TRY TO MAKE SURE THAT WE ARE EMPLOYING ANY STRATEGY THAT’S BEING USED NATIONALLY WITHIN OUR REGION AS WELL. WHAT DO PATIENTS OR PROSPECTIVE PATIENTS NEED TO KNOW COMING INTO THIS SITUATION IF THEY ENCOUNTER THE FACT THAT, YOU KNOW, A CERTAIN DRUG THEY NEED FOR A CERTAIN PROCEDURE IS NOT AVAILABLE, WHAT DO THEY NEED TO KNOW? HOW SHOULD THEY APPROACH THIS SITUATION? SO I THINK ONE OF THE THE BIGGEST, MOST IMPORTANT THINGS TO DO IS HAVE THAT GOOD COMMUNICATE STATION WITH THE PROVIDER AND YOUR PHARMACY TEAM AT THE AT THE ORGANIZATION WHERE YOU’RE RECEIVING CARE. WE ARE AWARE OF THESE CHALLENGES IS WE ARE WORKING VERY CLOSELY TO TRY TO MITIGATE ANY ISSUES FOR OUR PATIENTS AND WORKING VERY CLOSELY TO FIND ALTERNATIVE SOLUTIONS WHEN WE DON’T HAVE A PRODUCT AVAILABLE. IS THIS SOMETHING THAT THAT IS NEW, THE SHORTAGES, OR IS THIS SOMETHING THAT YOU’VE ENCOUNTERED SINCE THE BEGINNING OF TIME THAT SOMETIMES A DRUG IS JUST NOT AVAILABLE? SO I WILL SAY IT SEEMS LIKE WE’RE SEEING MORE AND MORE OF THIS, BUT IT IS NOT A NEW PROBLEM. AND THIS IS SOMETHING THAT I’VE ENCOUNTERED THROUGHOUT MY CAREER AND UNFORTUNATELY, IT IS SOMETHING THAT WE’RE PROBABLY GOING TO CONTINUE TO SEE. BUT IT SEEMS YOU HAVE A LOT OF CONFIDENCE THAT, YOU KNOW, YOU CAN DEAL WITH IT IN THAT SITUATION AT THAT TIME SHOULD IT COME ABOUT. AND WE’VE BEEN ABLE TO DO THAT ALL ALONG. SO I DO HAVE GREAT CONFIDENCE IN BEING ABLE TO DO THAT IN THE FUTURE. SO IT’S WILL CONTINUE TO BE PROBLEMATIC, BUT WE’LL CONTINUE TO WORK THROUGH EACH OF THESE SITUATIONS. YOU ARE WATCHING WTAE WTAE LISTENS. WE’LL BE RIGHT BACK. WELCOME BACK TO WTAE LISTENS. WHETHER YOU LIVE IN ONE OF PITTSBURGH’S NEIGHBORHOODS OR ANY OF OUR OTHER SURROUNDING COMMUNITIES, TELL US ABOUT WHAT’S WRONG AND WHAT’S RIGHT IN YOUR AREA SO WE CAN LISTEN AND YOU CAN SEND US AN EMAIL WTAE LISTENS@HERTZ.COM AND TUNE IN NEXT WEEK AS WE KICK OFF OUR MONTH LONG BACK TO SCHOOL SERIES, WE’RE ADDRESSING A RANGE OF ISSUES THAT IMPACT KIDS IN THE CLASSROOM. THAT BEGINS SUNDAY, AUGUST 13TH. WE THANK YOU FOR JOINING US THIS MORNING AND HAVE A GREAT WEEK.

WTAE Listens: Drug shortages impacting patients

Updated: 11:30 AM EDT Aug 6, 2023

From hospitals to pharmacy shelves, drug shortages are impacting patients across the country. On “WTAE Listens,” we’re learning how the medical field is rising to the challenge. Watch the latest episode in the video player above

From hospitals to pharmacy shelves, drug shortages are impacting patients across the country.

On “WTAE Listens,” we’re learning how the medical field is rising to the challenge.

Watch the latest episode in the video player above

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