Drug Switching Due To Drug Shortage - A Multi-Centre Study In 59 German Hospitals

Aim During the last years, drug shortages by pharmaceutical companies became a major difficulty in Germany. This problem results in an increasing amount of unplanned drug switching due to drug shortages (DSS) in German hospital pharmacies. The aim of this multi-centre analysis is to assess the drug shortage situation in German hospitals.Method Documentation of planned and unplanned drug switching (DS) in an prospective multi-centre study in 13 German hospital pharmacies providing the medication supply to 59 German hospitals (represents: 4.2% hospitals of the state hospital plan and university hospitals, reference year 2013). The number and type of drug shortages were evaluated for a period of one year.Results In 2013 drug switching of 1048 drugs in the 13 hospital pharmacies was documented. Of which were 31.6% unplanned DDS.The planned DS of 717 were due to strategic considerations. 331 DSS were triggered by 239 medicinal products which were not available because of a supply shortage. 127 (38.4%) DSS occurred in the first half of 2013, 204 (61.6%) in the second half. Conclusion 31.6% of the drug substitutions were caused by drug shortages and resulted in an unplanned drug switching to ensure medication stock and patient care. The higher amount of DSS (61,6%) in the second half of 2013 shows a further tightening of the drug shortage situation. Drug switching leads to process changes, an increased workload and determine an avoidable risk. Planned drug switching in hospital pharmacies should be performed carefully to avoid process changes that could affect patient safety. As only drug shortages were documented which lead to drug switching in the hospital pharmacy itcan be assumed that the actual quantity of drug shortages is significantly higher.