SAUSALITO, CA (ASRN.ORG) -- Two new surveys give a snapshot of how bad the drug-shortage problem has become.  The Institute for Safe Medication Practices has called the recent rash of shortages “unprecedented.”  Today, the American Hospital Association and American Society of Health-System Pharmacists reported what their members are saying.

The AHA says that 99.5% of the 820 community hospitals that responded to the group’s June survey reported experiencing at least one drug shortage in the past six months. A full 44% reported shortages of 21 or more different drugs.

All treatment categories were affected, hospitals said, with 80% or more respondents experiencing shortages of surgery/anesthesia, emergency care, cardiovascular, gastrointestinal/nutrition, pain or infectious disease drugs. And 66% of hospitals reported shortages of cancer drugs. Some 47% of hospitals reported experiencing a shortage of at least one drug on a daily basis.

Shortages occur for a variety of reasons, including the unavailability of raw ingredients, FDA enforcement actions that halt production, voluntary recalls, poor inventory management, changed product formulations and even shortage rumors, which can prompt hoarding, according to the ISMP. (Indeed, 85% of the hospitals surveyed by the AHA reported that they’ve purchased “excess inventory” of certain drugs to be sure they’re not caught short-handed.)

In addition, most hospitals in the AHA survey say they’ve implemented rationing or restrictions for certain drugs and that as a result of shortages, drug costs have risen. A separate analysis released in March estimated shortages were costing hospitals at least $200 million annually.

The consequences for patients may include delayed treatment, receiving a less effective drug or not getting a recommended treatment, though most hospitals reported those things happened “rarely,” the AHA says. The ISMP reported last September on near misses and deaths resulting from drug shortages.

Meantime, the American Society of Health-System Pharmacists surveyed directors of pharmacy and of the 353 that responded, more than 90% agreed shortages were associated with a greater burden and higher costs compared to two years ago. And 70% felt the available information on managing shortages was inadequate. It estimated an annual labor cost of $216 million a year.

The ASHP, AHA and other groups recommend that an early warning system be established that might give signs of a looming shortage, that obstacles be removed so that the FDA can streamline approval of drugs in short supply and that incentives be explored that might encourage drug makers to produce the drugs that are most needed.