More than 96 Percent of Health Systems Report Moderate to Severe Shortages of Injectable Narcotics

CHARLOTTE, N.C. (March 15, 2018)— A new survey of Premier members revealed more than 96 percent of member health systems are experiencing moderate-to-severe shortages of injectable narcotic medications, a problem that has grown over the last two months due to a manufacturing stoppage by the largest producer of these products. 

This shortage is having a particularly severe ripple effect in the market because of the complex nature of the drugs involved. Narcotics, including those in shortage, are subject to an allocation system imposed by the U.S. Drug Enforcement Agency (DEA), which caps the amount of raw material that can be used by any manufacturer in a given year. Despite the shortage and manufacturing delays that are expected to persist well into the second quarter of 2019, the DEA has not shifted those caps to allow other manufacturers to begin producing shortage injectable narcotic products. 

“Premier is intensely focused on reducing and managing drug shortages overall,” said Mike Alkire, Chief Operating Officer of Premier Inc. “But, we are extremely concerned about this particular situation. We know manufacturers are ready to step in and increase production, but they are unable to do so without approval from the DEA. We understand and support the DEA’s goal to be judicious about the production of narcotics, but we believe we are in the midst of a public health crisis. A temporary reallocation of supply quotas would allow others to step into the void, potentially addressing a multi-year shortage in a matter of months. The DEA has authority to make this adjustment today, and we urge them to take action.”

Without change from the DEA, more than 57 percent of Premier members report that the injectable narcotics shortage has affected patient care, including delayed or cancelled surgeries and/or decreased patient satisfaction with delivered care. In addition, nearly 86 percent of survey respondents said the ongoing shortage was contributing to increased costs because the health system was forced to source more expensive products for pain management (89 percent of respondents), self-compound products and/or divide vials (77 percent), outsource compounding to a third-party provider (62 percent) and/or revise order sets (60 percent).

Injectable narcotic drugs, such as morphine, fentanyl and hydromorphone, are used in a variety of inpatient hospital procedures, including surgical sedation and post-operative pain management. These critical medications are also used within intensive care units for trauma, burn or oncology patients.

“Premier is a leader in helping to stem the tide of opioid addiction ravaging the country, so we understand the DEA’s concern about increased production. But these are not orally administered pills. They are very specific injectable products used over a short period of time, primarily in the acute-care setting,” added Alkire. “The DEA should appreciate the security and care followed by providers and other participants in the healthcare supply chain when storing, handling and administering these medications.” 

The survey on the shortage of injectable narcotic medications was fielded from March 6-15, among members of Premier’s National Pharmacy Committee, Premier’s Pharmacy Contracting and Pharmacy Affairs Subcommittees and Acurity members. It reflects responses from 116 health systems across the nation.