American Society of Health-System Pharmacists

• APhA, ASHP, and NABP undertook a collaborative effort to address these challenges head-on during a recent invitation-only event , and identified transformative and actionable changes for the pharmacy and related communities.
• That's why NABP and its member boards of pharmacy have made supporting pharmacy staff well-being a high priority.
• The outcomes of the summit are a roadmap to building a more sustainable, healthier pharmacy workforce and workplace," said NABP Executive Director/Secretary Lemrey "Al" Carter, PharmD, MS, RPh.
• APhA, ASHP, and NABP's commitment to enhancing the well-being of the pharmacy workforce is centered around five themes in the report.

• SAN DIEGO, Aug. 24, 2023 /PRNewswire/ -- Today, PrecisePK announces the celebration of the 30th anniversary of its partnership with UC San Diego Health.
• This decades-long initiative has proven the success of using Bayesian precision dosing to improve patient outcomes.
• With other UC hospitals joining, PrecisePK is delivering state-of-the-art Bayesian therapeutic drug monitoring technology to a total of 9 prominent sites.
• PrecisePK and UCSD Health mark 30 years of partnership in vancomycin AUC precision dosing, leading others to follow.

• New England Life Care is nationally recognized as a nonprofit, mission-driven home infusion therapy and specialty pharmacy services provider affiliated with 60+ of New England’s premier medical centers.
• “As a home infusion pharmacy, NELC wanted to make sure we were prepared to support our member hospitals when instituting new procedures and protocols related to the new vancomycin guidelines, released in 2020,” stated Erica Sievert, Regional Director of Pharmacy for New England Life Care.
• New England Life Care is using DoseMeRx’s clinical decision support software to dose vancomycin and aminoglycosides.
• “We are thrilled to be working with the team at New England Life Care to better serve their patients while staying ahead of guidelines and protocols,” said John Hardesky, CCO of DoseMe.

• Past public ire over high drug prices has recently taken a back seat to a more insidious problem – no drugs at any price.
• Patients and their providers increasingly face limited or nonexistent supplies of drugs, many of which treat essential conditions such as cancer, heart disease and bacterial infections.
• The American Society of Health System Pharmacists now lists over 300 active shortages, primarily of decades-old generic drugs no longer protected by patents.

A generic problem

• The problem boils down to the nature of the pharmaceutical industry and how differently the markets for brand and generic drugs operate.
• Perhaps the clearest indication of this is the fact that prices of brand drugs in the U.S. are among the highest in the developed world, while generic drug prices are among the lowest.
• But once the patent expires, the drug becomes generic and any company is allowed to manufacture it.

Outsourced production creates more supply risks

• One of the consequences of generics’ meager margins is that drug companies outsource production to lower-cost countries.
• While overseas manufacturers often enjoy significant cost advantages over U.S. facilities, such as easy access to raw materials and lower labor costs, outsourcing production at such a scale raises a slew of issues that can hurt the supply.
• The COVID-19 pandemic underscored the country’s reliance on foreign suppliers – and the risks this poses to U.S. consumers.
• To ensure domestic supplies, the Indian government restricted the export of medications, disrupting the global supply chain.

Low profits hurt quality

• Manufacturing drugs to consistently high quality standards requires constant testing and evaluation.
• A company that sells a new, expensive, branded drug has a strong profit motive to keep quality and production high.
• That’s often not the case for generic drug manufacturers, and this can result in shortages.
• Thus, any hiccup in production or shutdown due to quality issues can affect the entire market.

Repatriating the drug supply

• It is hard to quantify the impact of drug shortages on population health.
• However, a recent survey of U.S. hospitals, pharmacists and other health care providers found that drug shortages led to increased medication errors, delayed administration of lifesaving therapies, inferior outcomes and patient deaths.
• Whether this approach is feasible on a broader scale is uncertain, but, in my view, it’s a good first attempt to repatriate America’s drug supply.