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COVID-19 Drug Shortages Looming, Especially in Acute Care

Pharmacists, both in healthcare and community settings, should be prepared for shortages of drugs used to treat COVID-19. Find out what medications are involved and why a leading healthcare improvement company suggests that geographic areas that don’t yet face inadequate supply almost certainly will in the near future.

CHARLOTTE, NC – Antimalarials and antivirals being touted as possible COVID-19 treatment, as well as antibiotics used to cure infections, are increasingly in short supply during the COVID-19 outbreak in the United States.

That’s according to Premier Inc., a leading healthcare improvement company. The company recently released data warning that 15 drugs essential to providing care for COVID-19 patients are currently in or very near shortage. In addition to antibiotics, antimalarials and antivirals, other products at risk of inadequate supply are bronchodilators for keeping airways open and sedatives/neuromuscular blockers used to intubate patients.

Specially, the list includes include azithromycin, cefazolin, cefepime, chloroquine, hydroxychloroquine, acyclovir, ribavirin, valacyclovir, albuterol, cisatracurium, rocuronium, fentanyl, midazolam, propofol and norepinephrine.

With access to comprehensive data on purchasing patterns and current fill rates, Premier documented that those products both experienced the highest spikes in demand during March and also were unable to be supplied in requested quantifies. Both are early warning signals for shortages, according to the company.

The survey was conducted March 20-25, 2020 and involved responses from 377 unique hospitals and health systems in 42 states, as well as about 100 long-term care, home infusion and retail pharmacies in 38 states.

The highest demands were in COVID-19 hotspots such as New York, raising the possibly that products could move from regional shortages into national shortages as the disease spreads to additional communities.

“Increased demand for these products will clearly put pressure on manufacturers’ safety stocks, creating shortages that could worsen with time unless we take fast action now,” explained Premier President Michael J. Alkire. “For commodity products, we can tap adjacent industries to begin production. But drug manufacturing is highly regulated, and it typically takes years and substantial investment to build additional capacity and gain U.S. Food and Drug Administration (FDA) approval. Even if the FDA expedited approvals, inspections and other actions, drug manufacturing cannot be stood up overnight. Moreover, there are also secondary concerns about where replacement ingredients will be sourced, as many of these drugs rely on active pharmaceutical ingredients (API) from overseas.”

Active shortages are far more common in the acute care setting, with 70% those respondents reporting at least one shortage for COVID-19 drugs, according to Premier. In the non-acute setting, such as community pharmacies, the number drops to 48%.

The most frequently reported shortages were antimalarial drugs, listed by 70% of hospital respondents, followed by bronchodilators (65%), antibiotics (40%), antivirals (38%) and sedatives (35%). In New York, however, 77%, 54% and 39% of hospitals reported shortages of antimalarials, antivirals and sedatives, respectively.