Healthcare Quarterly, 15(3) July 2012: 26-35.doi:10.12927/hcq.2013.23040

Healthcare Ethics

Ethical Framework for Resource Allocation during a Drug Supply Shortage     

Jennifer L. Gibson, Sally Bean, Paula Chidwick, Dianne Godkin, Robert W. Sibbald and Frank Wagner

Abstract

Drug supply shortages are common in health systems due to manufacturing and other delays. Frequently, shortages are successfully addressed through conservation and redistribution efforts, with limited impact on patient care. However, when Sandoz Canada Inc. announced in February 2012 that it was reducing production of a number of generic injectable drugs at its Quebec facility, the scope and magnitude of the drug supply shortage were unprecedented in Canada. The potential for an extreme scarcity of some drugs raised ethical concerns about patient care, including the need to limit access to some health services. In this article, the authors describe the development and implementation of an ethical framework to promote equitable access to drugs and healthcare services in the context of a drug supply shortage within and across health systems.

 

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    Comments

    scott leslie wrote:

    Posted 2012/09/18 at 03:04 PM EDT

    Retail pharmacists (or ‘Chemists’ as they were known) were the historical source for medications before the development of the modern day pharmaceutical manufacturing industry. Healthcare professionals and consumers should keep in mind that pharmacies, especially those that specialize in compounding, can be an alternative source for medications during a shortage. This is particularly true for medications that are no longer patent protected (genericized) and when the patented medication that is in short supply is a longer acting (patent protected) version of an off-patent medication. Just this month a shortage of a sustained released medication for Crohns left many patients scrambling to find supply, but the original non-sustained release substance was readily available in powder form for pharmacists to compound with. Patients who understood what compounding pharmacies can do (in conjunction with their physician) were able to get capsules of the short acting substance compounded. This meant they had to take the medication 3 times per day instead of once a day but it allowed them uninterrupted therapy. Anybody who has Crohns or knows someone who does can appreciate how important maintenance therapy can be.
    Compounding pharmacies can play a vital role in situations where medications fall into supply problems or where there are discontinued for business or financial reasons rather than medical reasons.

     

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