Or they improvise in other ways. In the case of Fentanyl, for example, several pharmacists said they had to divide large-dose vials of the painkiller into smaller doses. That is a labor-intensive effort, especially because it is a controlled narcotic and every use must be documented. Hospital officials agreed that companies should be required to give plenty of warning when the drug is coming off the market or will be in short supply. PhRMA, the pharmaceutical industry's trade association, recently convened a meeting to discuss the issue with FDA staffers, doctors, pharmacists and hospital representatives.
Individual companies have to address it for their individual circumstances.
There is little dispute that the number of drugs that are in short supply is growing, although there is confusion about when shortages start and when they are resolved. Of the FDA's roster of hundreds of drugs it categorizes as medical necessities, seven are on its shortage list. Keeping lists The American Society of Health-System Pharmacists, which tracks a more extensive number of drugs, says about 20 are in short supply. The society has become a clearinghouse for reported shortages around the country. Joseph Deffenbaugh, of its professional practice and scientific-affairs division, said he received reports from hospital pharmacists of 15 to 20 shortages in February, an additional 15 to 20 in March and at least 20 more in April.