title: Impact of Drug Shortages on Health System Pharmacies in the Southeastern United States.
abstract: BACKGROUND
  Drug shortages have become all too common and affect all aspects of the health care delivery system. The increased number of drug shortages has had a negative impact on patient care as well as costly financial implications.
  
  
  OBJECTIVE
  This article identifies the current problems and negative outcomes drug shortages have caused and provides a framework for how to best prepare for and combat future shortages. It highlights specific problems faced by health care system pharmacies in the Southeastern United States and the managerial responses to address these shortage situations.
  
  
  METHODS
  A 34-question, multiple-choice survey was distributed to pharmacy directors in North Carolina, South Carolina, Georgia, and Florida.
  
  
  RESULTS
  Of 549 surveys distributed, 219 (40%) responses were received. Respondents reported that drug shortages cause 1% to 5% error rates in hospitals and that 60% of the time drug shortages create unsafe conditions for patients and staff. Many of the respondents reported a 300% to 500% markup on medications on the shortage list. Seventy-six percent of institutions have autosubstitutions for drug shortages that have been preapproved by Pharmacy & Therapeutics Committees.
  
  
  CONCLUSIONS
  The causes of drug shortages are multifaceted, and the safety and financial implications can be costly. In the short term, health care institutions can utilize pharmacists to assist in circumventing the drug shortage problem. The combined efforts of all health care professionals, the US government, manufacturers, and the lay public are necessary to bring awareness and plausible solutions to the drug shortage problems in the long term.
authors.affiliation: Assistant Professor, Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina , Columbia, South Carolina.
authors.forename: Celeste R
authors.initials: CR
authors.lastname: Caulder
authors.affiliation: Drug Information, Palmetto Health Richland , Columbia, South Carolina.
authors.forename: Brenna
authors.initials: B
authors.lastname: Mehta
authors.affiliation: Associate Professor and Vice Chair, Department of Clinical Pharmacy and Outcomes Sciences, South Carolina College of Pharmacy, University of South Carolina , Columbia, South Carolina.
authors.forename: P Brandon
authors.initials: PB
authors.lastname: Bookstaver
authors.affiliation: PGY-1 Pharmacy Resident, Carolinas Medical Center , Charlotte, North Carolina.
authors.forename: LaVetra D
authors.initials: LD
authors.lastname: Sims
authors.affiliation: Director of Pharmacy Services, Oconee Medical Center, Seneca , South Carolina.
authors.forename: Bill
authors.initials: B
authors.lastname: Stevenson
keywords: drug shortage; medication error; price gauging