Premier Inc. Data: As COVID-19 Cases Spike, Demand for Drugs Used to Treat Related, Co-Morbid Conditions Also Soars

CHARLOTTE, N.C. — Premier Inc. (NASDAQ: PINC), a leading healthcare improvement company, today released new data finding that as COVID-19 cases peak, so does demand for drugs used to treat cardiovascular conditions and blood clots.

According to the latest data, between 40 and 50 percent of COVID-19 hospitalized patients have some form of cardiovascular disease, making them more susceptible to arrythmias, heart attacks and septic shock. To manage these cases, Premier’s purchasing data shows that demand for amiodarone, a drug used to reduce the risk of late onset cardiac arrest and manage arrhythmia, increased 66 percent nationally in the first quarter of 2020 when compared to the same period last year. In hotspots like New York, demand for amiodarone was more than double the national average, soaring by 152 percent.

Similarly, Premier data shows two key drugs to manage septic shock, norepinephrine and vasopressin, also experienced higher demand nationally, with orders increasing by 122 percent and 66 percent, respectively. In New York, demand soared by 421 percent for norepinephrine and by 121 percent for vasopressin.

In most cases, orders for these drugs were able to be fulfilled, with the exception of norepinephrine, which has historically been in short supply and has a monthly fill rate of 55 percent in New York, meaning that just over half of the quantities ordered are able to be supplied. Low fill rates of norepinephrine have been linked to a 3.7 percent increase in patient mortality and $13.7 billion in losses to the healthcare system. A healthy fill rate is considered to be 80 percent or higher.

“For the most part, our data shows supply has been able to keep up with demand for these drugs and we have not seen widespread shortages – but we were very lucky,” says Premier President Michael J. Alkire. “Drugs such as amiodarone and norepinephrine were problematic even before COVID-19, rolling on and off the FDA drug shortage list for years. Now is the time for the country to act proactively to ensure drugs needed to treat these conditions are available in abundance, and that we don’t incur shortages should demand increase again with a resurgence of disease.”

Similarly, research also shows that between 25 and 40 percent of all patients hospitalized with COVID-19 develop blood clots, and clinical guidelines recommend that all COVID-19 patients receive medication upon admission to prevent clotting. In hotspots like New York, Premier data shows anti-clotting medication enoxaparin has seen demand spike by 46 percent in the first quarter of 2020 when compared to the same period last year.

Considering the increase in demand for drugs associated with COVID-19, Premier is working to ensure that the supply of these products is protected and readily available should cases spread to other communities. In addition to recommendations Premier has put forward to deal with drugs used to treat COVID-19, Premier recommends additional measures specific to the drugs used for co-morbid conditions, including:

• Manufacturers of these drugs should work proactively with organizations such as Premier to forecast demand and increase capacity/supply to avoid shortages.
• The U.S. Food and Drug Administration (FDA) should ensure there are at least three unique manufacturers of active pharmaceutical ingredients (API) and at least three unique manufacturers of finished dose form (FDF) for each of these drugs. To the extent possible, at least one API and at least one FDF should be domestic.
• The FDA should proactively expand its temporary guidance for drugs eligible to be compounded to include amiodarone to allow for surge capacity.
• These drugs should be added to the Strategic National Stockpile and a minimum 90-day supply be maintained based upon utilization in hotspots such as New York.
• Distributors should work with organizations such as Premier to create a dynamic allocation system that accounts for surge demand and prioritizes the needs of acute care providers.

“For commodity products, we can tap adjacent industries to begin production,” continues Alkire. “But drug manufacturing is highly regulated, and it typically takes years and investment to build additional capacity and gain FDA approval. Even with an expedited approval process, manufacturers will not be able to produce pharmaceuticals in greater quantities overnight, which is why we need action today. Taking these steps now will ensure that we don’t run into shortages later for some of our most critical medications providing treatments to our most vulnerable citizens.”