Jack E. Fincham, PhD, RPh
Jack E. Fincham, PhD, clinical pharmacy faculty affiliate in the Osher Lifelong Learning Institute, University of Arizona, Tucson. OLLI.Arizona.edu
Bottom Line: As the global effects of the new coronavirus are being felt, there are concerns that drug shortages may occur. Who is most at risk—and what to do…
As the tumultuous effects of the new coronavirus pandemic are being felt worldwide, hand-washing and social distancing aren’t the only steps you should be following to stay safe. You also should check your supply of the medications you regularly take.
Here’s why: Close to 90% of active drug ingredients for generic medications are manufactured in China, which has been significantly impacted by the illness caused by the new coronavirus (COVID-19).
To complete the entire manufacturing process, most of the medications that get dispensed by your pharmacy have to travel along an international supply chain that also includes India and other countries. For brand-name medications in the US, it’s been estimated that 70% are manufactured in foreign countries.
The FDA has been monitoring the drug-supply chain, but the increasing international spread of the new coronavirus recently caused the federal agency to suspend inspections of drugs overseas, which threatens the quality of those manufactured products. That includes temporarily pulling inspectors out of China, which is the largest source of drug ingredients for aspirin, ibuprofen (Motrin) and penicillin.
If you are taking a drug that can’t be interrupted, it is wise to plan for the possibility of a drug shortage.
Other things besides the recent coronavirus pandemic have caused drug shortages. For example, natural disasters, such as the hurricane that struck Puerto Rico in 2017, have triggered shortfalls of certain medications. Shortages also have occurred when drug products are abruptly discontinued.
Medication shortages are most likely to affect older, lower-priced drugs that don’t provide significant financial gain for manufacturers, such as the fluoroquinolone antibiotic gemifloxacin (Factive).
There are shortages for the following medications (at press time)…
Other medications, such as certain injectables and anti-epileptic and antipsychotic drugs, also are in short supply. People who take any of these drugs are more vulnerable if new shortages occur due to the coronavirus outbreak. For a list of current drug shortages, check the FDA website, www.AccessData.FDA.Gov/Scripts/DrugShortages.
Older antibiotics, such as penicillin, also are susceptible to shortages. Antibiotics, of course, are not used to treat viral infections, but secondary bacterial infections can occur with such illnesses and require antibiotic treatment.
You also need to be alert to possible shortages if you take a drug that causes side effects if the medication is stopped suddenly. These include prescription pain medicines, certain antidepressants and some blood pressure medications, such as the beta-blocker bisoprolol (Zebeta) and the angiotensin II receptor blockers irbesartan (Avapro) and losartan (Cozaar).
If you take medication for one or more of the following conditions, it’s important that you maintain an adequate supply of the drug to control the condition…
Start by talking to your doctor. Especially if you’re taking medication for one of the conditions listed earlier, ask your doctor to write a prescription for a 90-day supply. Most insurance companies and drug plan providers are already easing up on restrictions for 90-day supplies.
If you run into problems, ask your doctor’s office for help or consult your pharmacist for advice. If the larger refill you’re requesting doesn’t coincide with your refill date, your doctor can call your prescription drug plan provider and explain why the medication is essential for your health. With the doctor’s prescription and advocacy on your behalf, the provider may be more apt to approve the larger refill.
You should also ask your doctor if there are alternative medications that you can take if you have difficulty getting your regular medication. For example, if you take a beta-blocker, there may be other medications in the same class of drugs that are available and will have the same effect.
If you still have trouble getting or paying for a 90-day supply, an online pharmacy might be able to provide your medication. Important: To ensure that you are using a reputable online pharmacy, consult the website of the National Association of Boards of Pharmacy (nabp.pharmacy/programs/dotpharmacy, click on “Pharmacy Verified Websites”).
For information on online Canadian pharmacies, consult the website of the National Association of Pharmacy Regulatory Authorities (napra.ca/online-pharmacies). Ask your doctor to fax a written 90-day prescription and have the medication sent to you.
While you’re reviewing your prescription-drug supply, also make sure to have some commonly used over-the-counter (OTC) medications on hand. It may be best to buy these now. Here are OTC medications that are useful for everyone to have in their medicine cabinets…
Helpful: Look for liquid versions of any oral medications that might be needed for children or adults with swallowing difficulties. Plus, get disinfectant wipes, which are needed for certain medical treatments.
Also: Find out if your pharmacy or other pharmacies in your area will deliver or mail medicines in case you get quarantined at home. Although hand sanitizers are already in short supply, you can make your own by mixing isopropyl alcohol (at least 60%) with aloe vera gel or glycerin. Use one-third aloe vera and two-thirds alcohol.
While it’s prudent to seek a 90-day supply of medications, it’s important to avoid stockpiling drugs, as we have seen with people hoarding face masks, hand sanitizers and toilet paper. This can turn a potential shortage of any product—including medications—into an actual shortage.
With the coronavirus outbreak subsiding in China and the massive quarantines that slowed their workforces being loosened, production of drug ingredients is resuming there. But other countries along the production chain may still have problems, especially India, so don’t panic…but do plan ahead.
