Key Drugs Join PPEs on List of Front-Line Shortages

What your doctor is reading on Medscape.com:

APRIL 02, 2020 — First it was a critical shortage of personal protective equipment. Then pleas for more ventilators to sustain patients with COVID-19 and providers to care for them. Now, multiple sources are reporting deepening shortages of the drugs needed to help ventilate patients and keep them sedated.

Shortages are already evident for albuterol; neuromuscular blockers and sedatives, including fentanyl, midazolam, and propofol; and vasopressors for septic shock, even as orders increase exponentially.

The rates at which hospitals traditionally had been able to fill orders for ventilator-associated drugs was 95%, Dan Kistner, PharmD, told Medscape Medical News. 

“These classes of drugs have dropped to 60 or 70% in the last month alone,” said Kistner, senior vice president for pharmacy solutions at Vizient, a group purchasing organization that negotiates medicine contracts for about 3000 hospitals and healthcare facilities in the US.

“Every day it’s dropping 2 or 3 additional percent,” he continued.

Demand “Unprecedented”

The demand is simply “unprecedented,” he said, adding that the shortages are piling up even after elective surgeries have been put on hold.

A California nurse’s tweet in a nationwide thread of tweets under #WeNeedMeds poignantly described the consequences of severe shortages of some of these drugs. “Please do not put me on a vent if you can’t keep me sedated,” she writes. “I understand the alternative is death.”

Esther Choo, MD, MPH, an emergency physician at Oregon Health &  Science University in Portland, tweeted: “Those ventilators can’t really be used without a similarly vast supply of coupled medications to get people *on* the vents — and keep them on humanely. Hospitals are already experiencing shortages, before we even hit disease apex.”

15 Drugs at or Near Short Supply

Healthcare improvement company Premier, based in Charlotte, North Carolina, this week released a report that found 15 drugs used for COVID-19 care are in shortage or close to being in short supply at the same time demand is skyrocketing, particularly in New York.

Their data differ slightly from Vizient’s but still show increasing numbers of orders going unfilled.