Hospital drug shortages have the potential to put patient lives at risk. At St Vincent’s, there are two people integral in managing these shortages: Senior Pharmacist Daniel Lim and Pharmacy Procurement Manager Danielle Avery.
They have developed a system through meticulous research and supply chain knowledge. Together, they have established a broad network of resources both externally and internally, allowing them to formulate and successfully execute robust plans to tackle each critical shortage.
The constant supply of medications is dependent upon a number of things that can change, sometimes very suddenly. Things like raw material shortages, complicated tendering processes, manufacturing plant closures, changes to contract arrangements and transportation delays can all impact the supply of medications.
When a variety of these factors impact the market at the same time, it’s virtually impossible to predict, such as in 2016, when we had an unprecedented shortage of medications affecting hospitals across Australia. Daniel calls it “the perfect storm”.
“Australia experienced a severe shortage of workhorse antibiotics late last year. If we failed to holistically address the shortage, effective treatment of life threatening infections could be compromised”, he said.
The shortage also struck the painkiller fentanyl this year, which is used in most surgical procedures, prompting our Director of Anaesthesia and Acute Pain Medicine, Professor David Scott, to call for tax incentives for companies to manufacture critical drugs locally in Australia.
“Given these shortages affected several critical mainstream drugs, most with no viable alternative and potentially devastating consequences on patient care, we had to work with urgency and pool all available resources,” said Daniel. “Fortunately, all the hard work paid off and we were able to avoid any significant adverse burden to our patients”.
There are almost 500 thousand drug transactions a year at St Vincent’s, worth millions of dollars. As widespread shortages still plague the market today, with approximately 375 reported drug lines currently unavailable or in short supply, Daniel and Danielle’s work in this space is inevitably ongoing.
Managing shortages well also results in financial benefit. The system that the team put in place avoids having to go down expensive pathways in sourcing medications.
“We didn’t have any budget blowouts because we managed it the way we have. We haven’t had to resort to procuring expensive overseas stock,” said Danielle.
The primary goal underpinning their work is to ensure that all patients can access the medication they need for their treatment.
“My job has a knock on effect for everyone that has any medication in this hospital and I’m accountable for every patient that comes in the door. So I can’t drop the ball,” said Danielle.
“Working in ICU, I know what it really means when you say ‘a life hangs in the balance’. Not being able to provide patients with the medications they rely on to get better is not an option for me,” said Daniel.
“Imagine if the patient was a loved one”.