CHICAGO — In response to an uptick in national drug shortages that threaten patient care and safety, physicians at the American Medical Association’s (AMA) Special Meeting of its House of Delegates (HOD) adopted policy underscoring drug shortages as an urgent public health crisis. The move reinforces and builds upon existing AMA policy that outlines a comprehensive framework to address ongoing drug shortages, which have been exacerbated during the COVID-19 pandemic.
The newly enhanced policy updates the AMA’s approach to mitigating drug shortages, specifically related to manufacturing innovations, global supply chain transparency, and drug maker incentives.
It includes a number of recommended steps, ranging from supporting continued analysis of the root causes of drug shortages to urging drug makers to accelerate adoption of advanced manufacturing technologies. The policy also reiterates AMA’s call on the federal government to continue to examine and consider drug shortages as a matter of national security.
“As the COVID-19 pandemic has illustrated, shortages of critical drugs can have a major impact on patient health. That’s why it’s essential for physicians to have access to the right drugs in order to provide high-quality care for our patients,” said AMA Immediate-Past Board Chair Jesse M. Ehrenfeld, M.D., M.P.H. “While this pandemic has exposed vulnerabilities in the global medicine supply chain, the AMA remains committed to working with stakeholders to act quickly on solutions that alleviate supply shortages now and in the future.”
While hospitals have experienced various drug shortages for decades, an unprecedented influx of critically ill patients due to COVID-19 has driven up the number of medications in short supply. Many of the drugs currently facing shortages are common injectable medications required for routine hospital patient care and necessary for ventilator support—such as analgesics, sedatives, and paralytics.
The AMA has partnered with multiple stakeholders to increase drug supplies and ease regulations amid the COVID-19 pandemic, including successfully urging the U.S. Drug Enforcement Administration (DEA) to increase limits for some injectable controlled substances to meet increasing COVID-19 demands and joining other leading health organizations in calling for responsible ordering, prescribing, and dispensing of potential COVID-19 medications.
The top five classes of drugs in short supply are central nervous system medications, antimicrobials, cardiovascular medications, ophthalmic and chemotherapy agents. In 2018, 55% of the medications with shortages were injectable, though this has decreased to 39% in 2019. While the reasons behind drug shortages can vary, a recent U.S. Food and Drug Administration (FDA) report estimates that more than 60% of shortages from 2014 to 2017 were due to manufacturer quality issues. The report cites a lack of incentives for manufacturers to produce lower-profit drugs and invest in quality management programs as factors.
The AMA’s new policy underscores the need to address increasing rates of new drug shortages and ongoing supply challenges for essential medications. Recognizing that prescription drug shortages have a widespread impact on patient care and treatment, the AMA remains committed to working collaboratively with other stakeholders to further evaluate and implement recommendations that contribute to solutions for this critical public health issue.
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