Frequent medication shortages have led to various allocation and rationing methods by pharmacy practice managers and/or pharmacy leaders (PPMs), according to results of a survey published in JAMA Internal Medicine.

Researchers conducted interviews with 9 health-system pharmacists about their experiences with drug shortages. Using the information garnered from these interviews, they sent a survey to members of the American Society of Health-System Pharmacists who self-identified as PPMs.

Of the 719 respondents (65.0% response rate), 53.0% self-reported as men. The reported median number of years in practice was 10. Respondents reported that they practiced in community hospitals (63.0%), academic (19.9%), or academically affiliated hospitals (17.1%); they were most frequently from hospitals with >400 beds (34.0%) and least frequently from hospitals with <100 beds (15.2%).

In the preceding year, all respondents encountered drug shortages and the majority reported >50 shortages (69.2%). In addition, the vast majority indicated that they had an average <1 month from notification to active shortage (92.4%); 81.3% reported medication hoarding and only 36.0% informed their patients that their care included rationing.

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The investigators noted that drug rationing occurred more frequently at academic hospitals and academically affiliated hospitals than community hospitals, and in hospitals with >300 beds.

“This survey of PPMs suggests that more systematic approaches are needed to address the common problem of drug shortages and consequent drug rationing,” the authors write. “Progress in this area would be furthered by research to better understand patient and physician preferences for disclosure and the association of different management strategies with the outcomes of high-risk groups.”


Hantel A, Sielger M, Hlubocky F, Colgan K, Daugherty CK. . Prevalence and severity of rationing during drug shortages: a national survey of health system pharmacists [published online March 25, 2019]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.8251