Drug shortages disrupt healthcare and waste time. They also adversely affect patients: rationing or even unavailability of treatments exposes patients to a worsening of their condition; patients may not be vaccinated or may be unable to follow the normal immunisation schedule; they may receive an alternative treatment that is less effective, causes medication errors or requires adjustment of a previously stable treatment. The situation may cause them anxiety, a greater financial burden, etc.

Errors, some of them fatal, have occurred when the unavailable drug is replaced with another.

In late 2019, the French Medicines Agency (ANSM) warned of the risk of errors related to certain replacement medicines, particularly imported ones. This is also the case in 2020, amidst shortages of medicines used to treat patients with covid-19.

Preventive measures are often suggested to patients and healthcare professionals only after errors have occurred. A systematic analysis of the risks associated with replacement drugs would make it possible to anticipate potential errors by relabelling and repackaging, providing dose equivalence tables and alerting users to any additional risks.

It is in the best interests of healthcare professionals and patients alike to report any adverse events related to drug shortages.

©Prescrire 1 September 2020

Source: "Drug shortages: report the sometimes-serious adverse events they cause" Prescrire International 2020; 29 (218): 220-222. Subscribers only.

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