ASHP guidelines on managing drug product shortages.

Short-term back orders and long-term unavailability of drug products have been a challenge to pharmacy managers for many years. Nevertheless, these drug product shortages have been increasing in frequency and severity since the late 1990s. The causes are varied and involve all segments of the “supply chain.” Changes in policies and practices among these segments individually and collectively contribute to drug product shortages. The challenge for pharmacy managers is to enable the provision of seamless equivalent drug therapy at comparable costs. Managing drug product inventories and supply situations is particularly complex for health care organizations because of the large number of monotherapies and monoproducts available. Drug product shortages can delay and compromise patient care and increase total costs, including those of alternative therapies, delivery devices, and staff training. The department of pharmacy should take a leadership role in managing shortages by developing appropriate strategies and an awareness campaign. Strategies for dealing with drug product shortages are similar to disaster planning and risk management contingencies for major snowstorms, mass casualty events, temporary wholesaler shutdowns, and preparations made for the Year 2000. This guideline describes the factors contributing to drug product shortages and recommends a general process for inventory management in preparing for and working through shortage situations. Included are strategies for identifying alternative therapies, working with suppliers, and collaborating with physicians. Because of the differences and complexities in health care organizational arrangements and practice settings, some aspects of these guidelines may not be applicable. Pharmacy managers should use their professional judgment in assessing and adapting this guideline to meet the needs of their own settings and to comply with the health care organization’s policies and procedures.