Chart Review: Drug Shortages Related To Covid-19

Margaret Barnhorst, Health Care Policy Intern April 17, 2020

With the massive influx of COVID-19 patients, many hospitals are struggling to obtain the medications they need to treat patients on ventilators. According to new research from medical supplier Premier Inc., shortages are already evident for antivirals (Valacyclovir), antibiotics (Azithromycin, Cefazolin, Cefepime), vasopressors (Norepinephrine), neuromuscular blockers (Rocuronium, Cisatracurium), bronchodilators (Albuterol), and sedatives (Propofol, Midazolam, Fentanyl)—a combination of medicines that help treat patients on mechanical ventilators, keep airways open, control lung functions, reduce fevers, and manage pain. The demand for these critical drugs increased dramatically last month, with orders for antibiotics nearly tripling. Of note, the demand for Azithromycin increased 170 percent in March, and the demand for Cisatracurium increased 253 percent. Demand for Albuterol, a common medication in asthma inhalers, also rose significantly in March because of its use in easing respiratory distress in COVID-19 patients, therefore limiting the supply for asthmatic patients. As a result of this increased demand, the rate at which prescriptions are filled has decreased significantly, as seen by the number of unfilled orders in March. Before COVID-19 outbreaks, the average fill rate for ventilator-associated drugs was 95 percent, but it now ranges from only 51 percent (Cisatracurium) to 87 percent (Valacyclovir). In attempts to make these medications more accessible, pharmaceutical companies such as Pfizer and Teva Pharmaceuticals are adjusting production schedules to prioritize certain drugs, and the Drug Enforcement Administration temporarily increased production quotas for sedative drugs and medications necessary for patients on ventilators.

Data obtained from Premier Inc. COVID-19 Pharmaceutical Supply Chain Vulnerabilities Survey from March 31, 2020

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