PEORIA — While news stories on drug shortages and price spikes typically focus on individual consumers and the retail drug market, the problem has been huge for hospitals, which rely on the availability of hundreds of generic drugs to treat patients every day.
“You are seeing some issues in the doctor’s office, but not to the degree that we are seeing it in the hospital,” said Kent Lehr, vice president of strategy and business development at UnityPoint Health’s corporate offices in West Des Moines, Iowa.
At times as many as 200 drugs commonly used in hospitals have shown up on shortage lists, he said.
In an effort to address the issue, UnityPoint Health recently announced its participation as a founding partner in Civica Rx, a brand new not-for-profit drug company that plans to market some of the generic drugs hospitals use most. Governing members of Civica Rx include a few of the biggest players in the U.S. healthcare industry. As a founding member, UnityPoint Health will have a say in which drugs Civica Rx produces, said Lehr.
“Our chief pharmacy officer, Gary Robb, will be sitting on the drug selection committee,” he said. The company plans to produce 14 hospital-administered generic drugs this year. It will subcontract manufacturing and do its own manufacturing once it becomes an FDA approved manufacturer.
Drug shortages have been a fact of life in hospitals all over the country for about the last 10 years, said Ryan Taylor, regional director of pharmacy services for UnityPoint Health’s Peoria and Pekin hospitals.
“After the economic downturn, drug companies wanted to become more sustainable, and they began to look at some of these old products as not being profitable,” said Taylor. Older generic drugs don’t have high profit margins, leading some companies to quit manufacturing them, Taylor said. That led to a drop in supply and a rise in prices.
“Isoproterenol, for instance, is a medication with a wide array of FDA approved indications — asthma, cardiac arrest, congestive heart failure. It is a hospital-essential drug. At one point Isoproterenol sold for $2 per vial. At that price it wasn’t a viable drug to produce from the drug companies' perspective, so they stopped making it,” said Taylor. “Then the price soared as high as $2,000 per vial. The goal of Civica Rx is to find that fair and sustainable price for all.”
Roller coaster pricing is a problem. So are shortages. Over the last 10 years the UnityPoint hospitals in Peoria addressed the problem by forming a special committee to keep a close eye on the availability and cost of the drugs they use every day, said Taylor.
“We have a weekly meeting every Wednesday,” he said. “The pharmacy reps from all three hospitals sit down and look at what drugs we might run out of in the next two to four weeks. We have a spreadsheet on hand where we can look at the current quantity and compare that with our historical usage rate.”
If a drug is determined to be critically low, healthcare providers are alerted, and there are discussions about alternative therapies.
Careful monitoring has ensured patient care has not been compromised, said Taylor.
“The situation has been pretty unbeknownst to our patients,” he said. “There haven’t been any situations where we had to cancel procedures. But it is costly to hospitals that are already operating on slim margins.”
Both Taylor and Lehr see great potential for Civica Rx. Lehr said the partnership fits nicely with UnityPoint’s strategy of good patient experience.
“In a lot of business arrangements you don’t always see the direct benefit on the patient, but in this, you will. And I think you will see it really quickly,” he said.
Civica Rx is an innovative way to stabilize the supply of essential hospital-administered medications, which will ultimately provide better long-term care to patients and possibly even lower costs, said Taylor.
“This is a market disruptor, a much needed market disruptor.”
Leslie Renken can be reached at 686-3250 or firstname.lastname@example.org. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.