Drug shortages: The hidden public health crisis

When you think of a public health crisis, you think of natural disasters, a disease outbreak, or a food recall, and for good reason. All of those are high-profile issues that affect the health of communities, large and small.

When these crises occur, the healthcare community is at the center of the response, with hospital staff working alongside first responders, police, firefighters and other organizations.

But what happens when a public health crisis emerges within hospital walls?  Well, that’s happening with the drug shortage crisis going on right now, and it badly needs our attention.

According to the American Society of Healthy-System Pharmacists, as of December 2018, there are over 200 active drug shortages in the United States. This includes anesthetics, antibiotics, cancer-fighting drugs and other medicines essential for providing the highest quality care.

When hospitals lack access to drugs, there isn’t always an easy solution. Often, a drug shortage results in doctors moving forward with a treatment plan that is less than ideal – from limiting access to the best treatment options for cancer to affecting emergency departments’ ability to provide lifesaving care.

There are also rudimentary and serious ethical issues that need to be addressed such as the dire health consequences directly resulting from a few pharmaceutical companies’ monopolistic pricing behavior.

One of the most troubling recent examples involves a lifesaving tool used to rescue patients overdosing on opiates. The recent price hike of a naloxone autoinjector by more than 600% in three years (from $575 in July 2014 to $4,100 in January 2017) is morally questionable at best.

So, the crisis is grave and the question arises: what can we do about it?

Catholic Health Initiatives has joined Civica Rx, a not-for-profit generic drug company run by health systems, hospitals, and philanthropies. We believe this is a groundbreaking initiative that will change healthcare in the United States.

• Civica Rx is a collaboration in every sense of the word—a cross-functional team of pharmacists, physicians, nurses, executives, supply-chain managers, and others across many hospitals are working to identify which drugs have the most critical need.
• The governance of Civica Rx is setup in a way that no hospital or health system has an ownership stake. It is a partnership designed to prioritize affordable treatment and over one thousand health systems have expressed interest in participating in the company, representing more than a third of U.S. hospitals.
• Civica Rx is driven by an access-motive rather than a profit-motive. It is one of the first pharmaceutical companies that will place increasing access to the most critical hospital-administered drugs as its top priority 100% of the time.
• Both the FDA and DEA recognize the potential impact of this initiative and are interested in working with Civica Rx to move toward a future where drug shortages are a thing of the past.

While the initial drug offering has not been determined, at CHI, we couldn’t be more optimistic and excited about the impact that Civica Rx will have. It’s a shining example of healthcare leaders coming together to be the change they want to see.