The Impact of Drug Shortages on Florida’s Health Care System: Managing the Challenges

The healthcare industry in Florida is facing an ongoing struggle with drug shortages, a situation that many experts believe will become the new normal for pharmacies. According to the Food and Drug Administration (FDA), there are currently over 120 drugs in short supply, ranging from essential chemotherapy drugs to medications for respiratory conditions. A recent Senate report revealed a 30% increase in drug shortages from 2021 to 2022, and the American Society of Health System Pharmacists Drug Shortages List contains more than 233 entries.

Dave Lacknauth, an executive board member of the Florida Society of Health System Pharmacists, explains that dealing with pharmaceutical shortages has become a familiar challenge within the healthcare industry. Lacknauth, who also serves as the executive director of pharmaceutical services at Broward Health, emphasizes that hospitals and pharmacists have developed strategies to manage the supply chain effectively, preventing panic buying and further depletion of supplies. He mentions that their pharmacies work to ensure procurement, often receiving allocations based on previous usage. If the supply of a specific medication is insufficient, hospitals pivot to alternative drugs that can provide the same treatment.

One of the key factors contributing to these shortages is the bankruptcy filing of Akorn Pharmaceuticals earlier this year, resulting in the recall of more than 70 products. This move significantly impacted the availability of critical medicines such as albuterol, a vital breathing medication. Akorn was one of only two domestic manufacturers, highlighting the vulnerability of the supply chain when there are limited sources of production.

However, drug shortages have been a concern in the healthcare sector for the past decade. In 2010, the FDA reported 178 drugs in short supply, which persisted through 2011 and encompassed essential drugs for cancer treatment, surgical anesthetics, emergency medicine, and intravenous feeding electrolytes. The U.S. House of Representatives conducted a study that identified several economic reasons for these shortages, including a price-driven mentality for generic drugs, leading to low or no profit margins for manufacturers. The report highlighted a reluctance to invest in advanced manufacturing or expand the generics business within the United States, as expanding production was deemed economically unfeasible. Furthermore, the study found that U.S. generic drug manufacturing facilities were operating at only 51% capacity.

The impact of drug shortages is particularly concerning for Florida, given its large senior population and the consequent demand for medication. Lacknauth believes that the state is more vulnerable to these shortages due to the higher volume of prescriptions required to meet the needs of retirees. The shortage of essential medications could potentially lead to delays in treatments for various conditions, including triple-negative breast cancer, ovarian cancer, and pediatric leukemia, as highlighted by the American Cancer Society (ACS).

Despite the challenges posed by drug shortages, Lacknauth expresses a moderate level of concern, rating it at around four or five on a scale of one to ten. He acknowledges that the impact is being felt and observed within the healthcare system but reassures that hospitals have been able to manage the situation by procuring medications through allocations to ensure continued patient care.

While drug shortages are not a new phenomenon, the House study found that they are now lasting longer, in some cases extending beyond eight years. Lacknauth suggests that healthcare workers should prepare for this new reality and develop strategies to effectively manage these shortages, ensuring that patients in the community receive the necessary treatment. The ACS also echoes these concerns, emphasizing that certain drugs used in cancer treatment have no effective alternatives, and delays in accessing them could lead to worse outcomes for patients.

As the healthcare industry in Florida adapts to the challenges of drug shortages, it remains crucial for policymakers, pharmaceutical manufacturers, and healthcare professionals to work collaboratively to address the underlying economic factors driving these shortages.