In the soon to be 244 years of Independence, the United States of America has been tested beyond measure on countless occasions, and each time Americans have risen to the occasion. Now, America is facing a monumental challenge yet again in a pandemic that continues to diminish prescription drug access. This ongoing COVID prescription medication shortage must be altered through a multi-pronged solution strategy that directly speaks to processes and procedures.
For a variety of reasons, the American prescription drug supply has experienced a shortage that requires swift and decisive action. The hope is that solutions will be forthcoming that alleviate and mitigate future demands, whether they be day-to-day challenges or those in times of a future pandemic. Strategies might include increasing domestic facility production, data analysis to identify drugs that are in high demand, and even individual prescription supply preservation. The Bill of Health (BOH), who took a deeper dive into the cause of Covid-19 drug shortages, proposes how best to manage the shortages and provides insights concerning short and long-term solutions that impact many aspects of the supply chain. Below are key factors provided by the BOH, and OptumRx, that are considered to be contributors to the drug shortages.
Key factors contributing to drug shortages:
- The first is demand for certain products that have been used to treat patients with the virus, like respiratory medications, pain medications, antibiotics, and anesthesia medications.
- U.S. dependence on foreign producers – drug shortages are frighteningly common even in the best of times. A 2019 FDA report noted that from 2013 to 2017, at least 163 drugs went into shortage.
- 50% of the world supply of raw materials shipped to drug manufacturers come from China. Additionally, since many pharmaceutical ingredients are manufactured in China, the COVID-19 factory slowdowns and in some cases, shutdowns have impacted the flow of drugs.
- It was pointed out that drugs are not stockpiled when there is surplus, because their effectiveness expires over a given period of time.
- Facility closures and labor shortages in China and a limit on the external distribution of some drugs from India who produce a large supply of the world’s generic drugs adds to the impact.
- Medications like hydroxy-chloroquine and chloroquine were both touted as possible treatments for COVID-19, which caused a significant impact on the availability of these medications.
Other drug shortage considerations:
- Ask your Pharmacy Benefits Manager (PBM) about their supply chain and drug availability, retail, and specialty, and establish weekly communication on specific drug shortages. A quick data analysis of your most used scripts will highlight potential problems.
- In-house PBM clinical resources are able to determine if there are drugs that might serve as alternatives — therapies that work equally well from a clinical perspective, that are equally as safe, and equally as accessible in terms of the economics.
- Guidance from the Centers for Disease Control (CDC) on dosage limitations can be set to preserve supply.
- Since we are in month three of COVID-19, PBM explanations and plans addressing the preceding factors should be well-formulated and specific.
The American public needs the assurance that shortages of the drug supply is not dependent on foreign production or even the specter of potential foreign blackmail for political gain. Beyond that, the public needs support in effective prescription management, health literacy and education to the safe and cost saving prescription alternatives and medical option resources that are available. Limiting drug waste is critical and can be effectively done through constant communication with those who are at risk of mismanaging their prescriptions. At the other extreme is the need to ensure that medications will be available when individuals refill their prescriptions. Encourage your Plan members to check with their pharmacy or mail order provider in advance to ensure that their medicines will be available when refills are needed. That way, when substitutions are necessary, members will have time to work with their physician and pharmacy to find suitable replacements.
Advanced Plan for Health’s healthy analytics platform, Poindexter, provides users with simple point-and-click tools and customizable reports that enhance understanding of Plan trends as a basis for improving key elements such as prescription management and compliance. This knowledge provides a foundation for the I Am! Nurse Advocate Program, where APH nurse professionals triage the client’s health plan using Poindexter’s health data to target individuals who need prescription medication management support and education. Click here to learn more today!
APH’s I Am! Nurse Advocacy Program provides only administrative, strategic, and analytical services and functions and does not make medical diagnosis, provide medical advice, or prescribe medical treatments or options.