Research Article: The current status and effects of emergency drug shortages in China: Perceptions of emergency department physicians

Date Published: October 9, 2018

Publisher: Public Library of Science

Author(s): Caijun Yang, Wenfang Cai, Zongjie Li, Amy Theresa Page, Yu Fang, George Liu.

http://doi.org/10.1371/journal.pone.0205238

Abstract

The shortage of emergency drugs in China is severe. This study aimed to characterize emergency drug shortages in China and to measure their effects.

An online questionnaire based on a literature review was sent to emergency department physicians in Chinese secondary and tertiary hospitals from November 2016 to February 2017. The survey asked physicians questions about their experiences with emergency drug shortages.

In total, 236 physicians from 29 provinces participated in the survey. According to their responses, 90.7% of the respondents experienced drug shortages during the last year. More than half of the physicians (65.7%) reported that drug shortages occurred at least once a month. Hospitals in the eastern and western regions of China had more emergency drugs in shortage than hospitals in central China, especially those with many inpatient beds (≥800). In addition, the shortage situation was more serious in secondary hospitals than in tertiary hospitals. More respondents agreed that original medicines, injections, essential medicines, medicines without alternative agents and cheap medicines were more susceptible to shortages than generics, oral medicines, nonessential medicines, medicines with alternative agents and expensive medicines, respectively. Most respondents thought that drug shortages always, often or sometimes affected patients [delayed therapy (62.6%), longer rescue and recovery times (58.9%) and higher costs (58.7%)] and physicians [inconvenience (81.0%), higher pressure (76.5%) and harm to patient-doctor relationships (72%)] and compromised hospital reputations (55.1%).

The shortage of emergency drugs in China is serious, especially in secondary hospitals located in eastern and western China. Emergency drug shortages have significant effects on patients and physicians.

Partial Text

A drug shortage refers to a situation in which a drug cannot meet the current or projected demand at the user level [1]. Over the last few decades, drug shortages have become a complex global health problem affecting both developed and developing countries [2]. Developed countries in Europe and North America have reported drug shortages, and 154 new shortages were reported in 2016, even after recent efforts by the U.S. government to solve this problem [3]. European pharmacists across 36 countries experienced drug shortage problems in 2014, and most reported that this problem occurred on a daily or weekly basis [4]. Ireland reported shortages of 64 drugs during a four-month period with an average duration of more than two weeks [5]. Developing countries have been heavily affected by drug shortages and many of the affected drugs are essential medicines. In India, 130 medicines on the Essential Medicines List and Rationalized Drug List were reported to be in shortage in 2013 [6]. In China, researchers identified 148 drugs in shortage from 2006 to 2015, most of which were cheap and essential medicines [7].

This study evaluated emergency drug shortages in China from the perspectives of physicians working in the emergency departments of Chinese hospitals. In total, 236 physicians from 29 of 31 provinces participated in the study. Their experiences with emergency drug shortages and the effects of these shortages on patients, health professionals and hospitals were characterized.

This study measured the levels of emergency drug shortages in China. Overall, the shortage of emergency drugs was critical and varied between different regions and different hospital levels. Currently, emergency drug shortages in China mostly involve cheap medicines. The shortage problem continues to affect the entire healthcare system, causing delayed therapy, longer rescue and recovery times and increased economic burdens for patients, inconvenience for physicians, and compromised reputations for hospitals.

 

Source:

http://doi.org/10.1371/journal.pone.0205238

 

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