How Drug Shortage Affects Anesthesiology Practices

by | Published on Sep 29, 2014 | Healthcare News

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When patients are about to have a surgery, their major concerns include the efficacy of drugs that they are put under. With the acute shortage of anesthesia drugs, anesthesiology practices are really struggling to alleviate this concern. According to the 2012 survey by the American Society of Anesthesiologists, around 98 percent of anesthesiologists experienced drug shortage in the U.S. Though the Food and Drug Administration (FDA) reported that the number of new drug shortage reduced to 38 from January to September 30, 2013 compared to 117 during 2012, ongoing drug shortages remains at more than 300 during and longer-standing. The reasons cited for the shortage include outdated manufacturing plants with limited capacity in the U.S. and the reluctance of pharmaceutical companies to provide incentives to produce more of generic drugs compared to high-cost specialty drugs. Let’s take a look into how this shortage affects anesthesiology practices.

Crucial Impacts of Drug Shortage on Practices

The ASA survey reveals the following critical impacts of anesthetic drug shortage on practices.

  • Use of Alternative Drugs – As per the survey, 96.3% respondents had to use alternative drugs. In order to make up for the shortage, the practices end up using more narcotics, which cause nausea and delayed awakenings in patients. Certain substitute drugs cause psychological effects as well. Many hospitals are increasingly concerned about patient safety issues as drug substitution at the last minute can pose real safety concerns. Moreover, there is difficulty in finding a suitable alternative drug and many practices need to borrow it from large facilities.
  • Alter the Procedure – More than half of the respondents (50.2%) said they had to change the procedure in some way owing to the shortage. The practices need to add extra effort for that and it will reflect on patient care as well.
  • Postpone Cases – Due to shortage of common anesthetic drugs including propofol and neuromuscular blocking agents, certain hospitals and outpatient surgical centers are forced to postpone surgeries indefinitely. The survey shows about 7% respondents had to postpone cases. This kind of delays can affect patient satisfaction and outcomes. Moreover, there would be increased costs for surgical set up, sterilization and arranging time for vacant room.
  • Cancel cases – According to the survey, 4.1% of respondents had to cancel cases because of the shortage. Apart from revenue loss, cancellation cause considerable inconvenience to patients and place both anesthesia professionals and patients at risk for adverse health outcomes.

Drug shortage can also result in medication errors such as wrong dose, wrong drug and wrong frequency. On the whole, the shortage can cause a great financial burden on practices while buying expensive alternative drugs, taking extra time and effort to manage shortage and addressing claim denials due to errors. A 2014 drug shortage survey found that U.S. hospitals spent an annual average of $229.7 million in additional costs between 2011 and 2013 as they were required to buy more expensive generic substitutes for drugs in shortage. Practices are required to find an effective way to manage their claim billing and revenue cycle.

Solutions to Address Shortage Effectively

  • Modify anesthesia techniques
  • Group purchasing of drugs
  • Utilizing in-house pharmacies to compound syringes
  • Conserve the drugs that are in short supply while there are other anesthesia options available
  • Timely communication between pharmacy and anesthesia staff
  • Implement a log-tracking system for billing, administration, receipt and reimbursement for drugs or take the help of experts for that.

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