Home' The Source : Third Quarter 2011 Contents Many members send those messages on to HealthTrust for advice.
Some are scams, involving counterfeit foreign drugs or non-FDA
approved alternatives. Some o ers come from grey-market specula-
tors who have acquired some of the product and hope to cash in on
the fear of scarcity.
Even if the product is genuine or an acceptable substitute, the risk
of contamination or improper handling and storage is always there,
Theobald adds. So pharmacies take considerable risks buying from
these type of sources.
In a recent HealthTrust survey, members cited lack of commu-
nication from drug manufacturers and distributors about potential
and real shortages as a chief complaint. HealthTrust works to bridge
the communications gap, Theobald says, by proactively contacting
manufacturers and distributors to validate rumored shortages.
HealthTrust also has created a process to identify, assess and re-
spond to drug shortages and supply interruptions. Work on the
process started about two years ago when HealthTrust's Clinical
Advisory Group began defining and compiling a list of mission-
"We put them in tiers depending on what response or commu-
nication we would need to provide and
how we would work with members and
vendors," Theobald says. (See sidebar on
HealthTrust's Drug Shortage Response
Program.) "We also created a process flow
to identify shortages earlier by working
more closely with manufacturers and
This close relationship means HealthTrust
can often secure at least some product and
then, based on past purchases, allocate it to
members based on that history, Willingham
says. This process helped keep members
supplied with propofol and, because of
HealthTrust's buying power, allowed them to purchase it at a much
better price than was available through outside channels.
"In certain circumstances, such as a brief interruption of supply, we
may advise members to increase their purchases temporarily to have
enough inventory to get them through the period," Theobald says.
In addition to conference calls, email and member newslet-
ters, HealthTrust will soon launch a page on its website called the
"Emergency Room," where members, vendors and other stakeholders
can share and find information related to drug shortages.
At a broader level, HealthTrust has joined others in the health-care
industry in supporting legislation intended to o set the impact of
shortages. (See sidebar on the latest in legislation.)
"We want to assure our members that we are looking into what
to do, and provide clinical support and information on possible al-
ternatives if there is an actual shortage," Willingham says. "We want
members to realize we are aware and doing all we can to alleviate the
situation, but many times there are limitations on what we can do."
"HealthTrust has put significant resources into this," Theobald
says. "It is one of the most pressing issues we are currently
dealing with." •
[ SourceBook ]
UNDER THE MICROSCOPE
HEALTHTRUST'S Pharmacy Services Group
has developed a drug shortage response
program for essential drugs that directly
impact critical medical practices. This program
provides members with medication shortage
awareness, recommendations for medication
restrictions, assessment of impact on current
stock, direction on procurement and clinical
guidance for alternative products.
The medications to be monitored for critical
shortages have been defined by members
of the HealthTrust's Clinical Advisory Group
and approved by members of the Pharmacy
Advisory Board to include a list of drugs which,
if unavailable, requires immediate action to
change critical medical practices due to lack of
an obvious viable alternative.
The guidelines during critical medication
shortages are developed for HealthTrust mem-
bership facilities in an attempt to provide rapid
and reliable information in the face of a critical
medication shortage. The recommendations are
based on HealthTrust's commitment to provide
evidence-based strategies for alternative
therapies when medications essential to critical
medical practices become unavailable.
These recommendations are intended to pro-
vide guidelines that fit most indications for the
medication in short supply, though physicians
have the ultimate prescribing authority.
Critical medications have been categorized
into three tiers, so members may have a better
understanding as to the resource expectations
provided by HealthTrust's Drug Shortage pro-
gram. When a shortage does arise, HealthTrust
posts information on SCRUBS, along with all
communications and supportive documents.
HealthTrust also alerts the Pharmacy Advisory
Board, Clinical Advisory Group and Buyers
Network as well as the entire membership. It
< HealthTrust's Drug Shortage Response Program >
The Latest on Legislation
ON FEBRUARY 7, U.S. Senators Amy Klobuchar (D-MN) and Bob Casey (D-PA) introduced the
Preserving Access to Life-Saving Medications Act (S. 296), which is intended to give the FDA powers
to address potential drug shortages.
If enacted, the bill would require manufacturers to warn the FDA of impending shortages (this
is not currently required); would ease restrictions on importing foreign drugs; and would speed up
the availability of reliable alternatives during drug shortages, which is currently a rare and involved
process, says John Theobald, PharmD, AVP, clinical pharmacy services, HealthTrust.
Opponents of the changes fear it would make it easier for counterfeit or contaminated drugs to
slip past detection and be used on patients.
"At the national and state level, HealthTrust supports legislation to identify likely solutions to
address this ongoing crisis," Theobald says.
continued on page 27
24 Third Quarter 2011 | The Source
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