December 23rd, 2010
11:44 AM ET
Shortages of some 150 crucial medicines have killed at least four hospital patients, according to reports from a patient safety group.
One of the hospital drugs in shortage is morphine, and two patients died of an overdose when hospitals substituted a more powerful drug instead, according to the Institute for Safe Medication Practices (ISMP).
Another patient died when doctors had to use diluted epinephrine, which is also in short supply. A fourth patient died when they couldn't get the antibiotic they needed to treat their infection.
"This is a big deal," says Michael Cohen, president of ISMP.
In an ISMP survey of some 1,800 doctors, nurses, pharmacists, and other healthcare practitioners, 80% said they'd had difficulty obtaining a suitable alternative for a drug that wasn't available.
About 150 drugs are currently in shortage, according to the American Society of Health-System Pharmacists, including sedatives, cancer drugs, and pain medications. The shortage has been going on since the spring.
In addition to the deaths, some surgical procedures and chemotherapy sessions have been cancelled because the necessary drugs weren't available, according to the ISMP survey.
"In some cases, it's possible to substitute one [cancer] drug for another, but [in other cases] there are not a great deal of options," says Dr. Richard Schilsky, a spokesman for the American Society for Clinical Oncology and professor of medicine at the University of Chicago.
There are various reasons for the shortage. Sometimes the source of raw materials for a drug has dried up. Other times, quality issues have closed down a manufacturing plant.
In other cases, it's about drug companies and profits.
"If the costs associated with making a drug begin to outweigh the profits, companies may wish to discontinue production of the drug in favor of a newer, more profitable product," Valerie Jensen and Dr. Bob Rappaport wrote this summer in the New England Journal of Medicine.
If the drug you need isn't available, it's probably not worth it to go to a different hospital, says Dr. Walter Curran, executive director of the Winship Cancer Institute of Emory University. "The cancer drug shortages are usually on a national basis so going to the other centers or other doctors is not of great value," he tells CNN.
The doctors and pharmacists we talked to said that if you're concerned, ask your doctor if the drug you need is in shortage, and if so, if there's an appropriate substitute. Discuss with your doctor whether there are different side effects from the substitute, and if doctors and nurses are familiar with how to administer it.
"We know these shortages are having a significant impact on patients and we continue to do all we can under our current authority to help resolve them," says Christopher Kelly, a spokesman for the FDA.
Caitlin Hagan and Miriam Falco contributed to this report.
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