Originally published by our sister publication Specialty Pharmacy Continuum

By Marcus A. Banks

Data analytics expertise can guide response to drug shortages, per a presentation at the ASHP Midyear 2024 Clinical Meeting & Exhibition, in New Orleans.

“How do you use 1× drug to treat 5× or 10× patients, especially if the shortage is prolonged?” asked Killian Rodgers, PharmD, during the presentation, referring to the challenge of stretching supply to meet the needs of far more people than intended.

Health systems can gather data to identify which drugs on the shortage list can be conserved so they last longer, as well as how to redistribute scarce drugs throughout the system to maximize access for everyone, Dr. Rodgers, the pharmacy coordinator for analytics at University of North Carolina (UNC) Health, in Chapel Hill, noted during a post-conference interview. As part of that strategy, he gathers data about drug usage levels and remaining inventory throughout the UNC system and presents that information to key stakeholders in easy-to-interpret charts and graphs.

Still, challenges remain. It’s not possible, for example, to closely track how many weeks of supply are available for every single shortage, Dr. Rodgers said. And if there’s an easily available substitute for a drug in shortage, that’s less critical to track than one that can’t be readily replaced. He cited, as an example, IV fluids, which went into severe shortage after Hurricane Helene struck western North Carolina last fall, with no substitutes available.

“As soon as that hit, we knew it was going to cascade through the entire market,” Dr. Rodgers recalled.

He and analytics colleagues quickly developed dashboards for tracking IV fluid availability. As the shortage took hold, the analytics team provided access to daily fluid use per individual patient in the electronic health record, so that clinicians could decide how to conserve without harming care. In some cases, standard practice before the shortage was to use more fluid than needed. A simple remedy of only hanging 250-mL fluid bags when appropriate, rather than a default 1-L bag, conserved resources.

The team also developed charts showing a steady decline in dextrose and saline use overall as the weeks went by, which showed UNC Health staff that conservation efforts were working.

The overall goal was to use no more than 50% of the level of fluids used before the hurricane, which the analytics team decided to reward with an Olympics-inspired medal system. If either the nursing or pharmacy units at a facility met this goal during a week, that facility got a silver medal on the dashboard that everyone at UNC Health could see. If both nursing and pharmacy did so, that facility earned gold.

“I still think it’s funny how well the medal system worked. When I heard from C-suite leaders asking why they weren’t gold, I knew we had something,” Dr. Rodgers said. However, just presenting data isn’t enough, he added—health system leaders also need to highlight success.

Dr. Rodgers reported no relevant financial disclosures.