“I actually have an inventory person on staff; her only job is to make sure that we’re getting in the drugs and finding them from alternative places,” he said. “And I know she probably spends a couple hours every day doing that, in addition to other technicians that are reaching out.”
Those efforts come amid 301 active drug shortages in the United States as of the first quarter of 2023, the highest since the first quarter of 2018, according to a report from the University of Utah Drug Information Service for the American Society of Hospital Pharmacists. This is a 24.3% increase since the first quarter of 2022.
Dr. Joshua Wollen, a clinical assistant professor at the University of Houston’s pharmacy practice and translation research department, said the three most prominent medication shortages are Albuterol, Adderall and Ozempic, which are typically prescribed to treat asthma, attention deficit hyperactivity disorder and diabetes, respectively.
"Those big three—Albuterol, Adderall and Ozempic—are probably the most pronounced ones because they’re so commonly used right now,” he said. “The majority of [drugs on shortage] are inpatient and are not used as widely as these three groups of drugs.”
Ongoing shortages
Hoffart said Magnolia Pharmacy fills hundreds of prescriptions and interacts with around 200-300 patients in a typical day. Staff have seen shortages of a number of medications, including ADHD medication and Ozempic.
“We’ve seen drug shortages, not only on some brand-name drugs but also on generic [drugs],” Hoffart said. “That has been quite a bit of a challenge lately in trying to deal with that because you don’t want patients to run out of meds, especially your regular patients.”
Within the active drug shortages, central nervous system drugs—which treat conditions such as ADHD, anxiety and depression—was the highest category shortage, according to the University of Utah Drug Information Service report.
Tomball’s Gloyer’s Pharmacy, which fills around 400 prescriptions in an average day, has also been dealing with drug shortages.
“Like 10% of what we’re going to order on a given day is a challenge,” pharmacist Stuart Berlin said. “We have our primary wholesaler, and then we have four or five or six other ones that we can potentially order from. So a lot of the time we can source it somewhere else, but it requires a little more work and effort.”
On the hospital side, Ursula Tachie-Menson, director of pharmacy services at Memorial Hermann The Woodlands Medical Center, is in charge of the medication distribution for the hospital. She said the hospital has struggled with medication shortages the last two years, noting shortages in Lidocaine, used for anesthetics, and even Tylenol.
She said, despite these shortages, the hospital has never been unable to give a life-saving drug to a patient.
“All we care about is our patients and making sure that we can give them what they need,” Tachie-Menson said. “From the littlest patients to the oldest patients, ... it’s often heartbreaking to see that we have things that they should be able to get easily is just a struggle to get.”
Behind the shortages
Wollen said the reasons for the shortages—including increases in demand and manufacturing problems—depend on the medication.
“The problem with demand increasing [is that] it’s really hard to upscale a production operation whenever the demand goes up a lot,” Wollen said. “So for the Albuterol, I’m more hopeful than I am for the Adderall and the Ozempic that it will be resolved quickly.”
Dr. Anupam Sidhu, a primary care physician at Houston Methodist Willowbrook Hospital, said she also believes the shortages are due to a combination of demand and manufacturing issues.
“The FDA is reportedly monitoring supplies and assisting with manufacturing where possible,” Sidhu said. “In regard to Ozempic, for instance, the massive numbers of new prescriptions being written are currently outnumbering the production capabilities.”
For 2022, 19% of drug manufacturers blamed supply and demand for U.S. medication shortages, and 18% cited manufacturing issues, according to the University of Utah Drug Information Service report.
“I think a lot of it right now just has to do with the manufacturing and the actual supply of the ingredients, and just getting that process turned around and getting the drugs in our store,” Hoffart said.
Meanwhile, 56% of manufacturers did not know the cause or would not provide a cause, according to the report.
Managing in the meantime
Amid these drug shortages, Tachie-Menson said Memorial Hermann The Woodlands Medical Center continually monitors shortages to see what it needs to be concerned about, what drug alternatives it has and how much of certain drugs it has in stock.
“We do a lot of prework to try and be proactive with some of these drug shortages,” Tachie-Menson said.
Hoffart said his staff spends time daily trying to source medicine for patients.
“If we get a prescription that’s not available, we’ll try our primary vendor or reach out to secondaries,” he said. “But if we can’t locate it from those vendors, then we are forced to going back to the physician and seeing if they’re willing to change it, make recommendations.”
Berlin said it does not happen often when a medication or an alternative is not available.
“I think, overall, most things have been somewhat intermittent,” Berlin said. “Like maybe we can’t get it for a week, but then the next week we’re able to finally get it in.”
If a patient’s medication cannot be sourced, their treatment plan usually starts over, Sidhu said.
“This takes time and effort, and it is frustrating to watch our patients suffer from a condition that would otherwise be well-managed,” Sidhu said. “We want our patients to feel well, and that is difficult if they can’t get their medicine.”
Hannah Brol contributed to this report.
