title: Drug Shortages: Patients and Health Care Providers Are All Drawing the Short Straw.
abstract: Drug shortages have been reported for > 35 years. Attention to this problem increased recently after the Sandoz crisis, in which a warning letter by the Food and Drug Administration caused supply changes that suspended the availability of numerous medications. The frequency of drug shortages has increased recently. In 2011-2012 alone, Canadian supply shortages occurred for > 1000 drugs (including 150 for cardiovascular diseases). These shortages lasted for an average of 4-5 months, increasing the workload for health care providers, producing impaired health, stress, and anxiety for patients, and increasing the risk of errors. The critical importance of drug shortages is increasingly recognized by members of the public, and health care providers must sometimes make major efforts to minimize their adverse consequences. Although data are limited, such efforts come at a price that patients and the health care system should not have to bear; they divert pharmacists and physicians from their already busy clinical duties and often require complex and risky adjustments in medical regimens. If drug shortages are here to stay, clinicians, drug manufacturers, and relevant organizations should work together to increase accountability for drug availability and adaptation to shortages, and to create more effective tools with which to anticipate and respond to critical supply fluctuations.
authors.affiliation: Département de pharmacie et Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, Montréal, Québec, Canada.
authors.forename: François
authors.initials: F
authors.lastname: Rinaldi
authors.affiliation: Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada; Montreal Heart Institute, Montréal, Québec, Canada. Electronic address: simon.dedenus@icm-mhi.org.
authors.forename: Simon
authors.initials: S
authors.lastname: de Denus
authors.affiliation: Montreal Heart Institute, Montréal, Québec, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Nguyen
authors.affiliation: Montreal Heart Institute, Montréal, Québec, Canada; Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
authors.forename: Stanley
authors.initials: S
authors.lastname: Nattel
authors.affiliation: Département de pharmacie et Unité de recherche en pratique pharmaceutique, CHU Sainte-Justine, Montréal, Québec, Canada; Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada. Electronic address: jf.bussieres@ssss.gouv.qc.ca.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bussières
mesh_terms: D002170:Canada; D004363:Drug Utilization / Q000706:statistics & numerical data*; D006282:Health Personnel; D006801:Humans; D061214:Patient Safety; D004364:Pharmaceutical Preparations / Q000600:supply & distribution*
chemical_list: D004364:Pharmaceutical Preparations