Drug Shortages: Advocacy in Action

Michael Ybarra, MD
YPS Secretary-Treasurer

The last few months have been a whirlwind of activity for AAEM, YPS, and RSA. Outgoing RSA President, Dr. Teresa Ross, and I have worked closely on a critical issue affecting every emergency physician: drug shortages.

As Dr. Ross eloquently wrote in the January/February 2012 issue of Common Sense, our ability to treat emergent and life-threatening medical conditions is seriously hampered by the national and international shortage of sterile injectable medications and even common oral medications (including antibiotics). My ability to treat a typical migraine has even been challenged by my hospital’s short supply of phenothiazines. I recently took an EMS call warning us they were bringing a peri-partum woman seizing. The ED medication Pyxis was out of magnesium, and the pharmacist let us know that we had fewer than 20 grams left in the entire hospital.

Drug shortages are impacting medical care, and we have taken to Capitol Hill to ensure that policymakers know. We have met with the legislative staff of key Senators and attended policy symposia and committee hearings. Our voices are starting to be heard, and we will continue to tackle this issue from a number of angles:

• Regulatory: Congress and the president have the authority to create rules that may help ease drug shortages. Late last year, President Obama issued an executive order that broadened the FDA’s reporting of critical drug shortages and expedited regulatory reviews. Congress has several bills working their way through committee that would change the government’s regulatory approach to drugs. AAEM, YPS, and RSA have endorsed current congressional legislation S. 296 and H.R. 2445, the Preserving Access to Life-Saving Medications Act.
• Financial: The congressional committees with jurisdiction over Medicare and Medicaid are examining ways to incentivize pharmaceutical companies to produce drugs that are on the drug shortage list. Other committees and agencies aim to penalize those who fail to report shortages or engage in price gouging.
• Partnerships: Key alliances with other specialty organizations and stakeholders augment our voice. We are working with the Drug Shortage Summit Steering Group (DSSSG) to provide input to legislators on specific bill language. Through the DSSSG we were able to include “emergency medicine drugs” as a suggestion for draft-bill language.

In the past months, we have met with congressional committees and legislative aids. We have also formed impromptu coalitions with other medical specialty organizations to address this critical issue and ensure that emergency medicine is well represented. However, our time spent on the Hill is greatly helped by the voices of our members. Write a letter encouraging your representative to support the Preserving Access to Life-Saving Medications Act and collaborate with congressional colleagues to address this issue in a comprehensive way!