IRVING, Texas — Vizient has identified 200 essential medications whose absence may threaten hospitals’ ability to provide immediate and high quality patient care, including 77 acute and chronic life-saving drugs that have no alternatives in the event of a supply disruption. The medications designated as essential with no alternatives include vital chemotherapy drugs and life-saving reversal agents such as epinephrine (allergic reactions) and naloxone (opioid overdoses). Vizient, which represents more than half of the nation’s acute care providers, is sharing this information to increase awareness of the fragility of the supply chain and to encourage both current and potential manufacturers to increase the available supply of these drugs.
“While any drug shortage can create numerous clinical and operational hardships, the lack of certain medications would pose a greater risk of negative outcomes due to the novelty of the drug’s use and/or the vulnerability of the patient to whom it is administered,” said Dan Kistner, group senior vice president, pharmacy solutions for Vizient. “Our purpose in sharing those designated as essential medications is to raise awareness of the importance of these drugs in emergency and routine patient care.”
Vizient conducted a comprehensive review of the World Health Organization’s Essential Medicines list, the Advanced Cardiac Life Support and Pediatric Advanced Life Support algorithms as well as direct input from front-line clinicians from Vizient’s member health systems. After review and analysis, Vizient’s pharmacy experts identified the medications that would be considered essential to the delivery of patient care using one of the three following definitions:
- Acute treatment drugs with no alternatives — Products used in acute and critical circumstances to sustain life and for which no alternatives are presently available (e.g., epinephrine, glucagon, magnesium sulfate)
- Chronic treatment drugs with no alternatives — Products used in chronic disease states or conditions where no alternatives are presently available (e.g., certain chemotherapy medications)
- High impact drugs — Products for which alternatives are available, but may be less clinically desirable and/or are more operationally difficult to use; also reflects products where the absence of one medication can affect therapeutically-related drugs (e.g., enoxaparin, vancomycin, propofol)
Of the 200 drugs designated by Vizient as essential, over 45% are currently included in its private label program, Novaplus. Also, through agreements within the newly launched Novaplus Enhanced Supply program, contracted manufacturers will supply 31 million additional units of propofol, magnesium sulfate, protamine, thiamine, phenylephrine, oxytocin, meropenem, enoxaparin, levothyroxine, glucagon and octreotide — all of which are considered essential medications by Vizient. The company expects to add more drugs designated as essential medications to its Novaplus Enhanced Supply program in 2020.
Scott Knoer, chief pharmacy officer at Cleveland Clinic said, “I applaud Vizient for working with their pharmacist members to identify these essential medications, and I fully support this crucial initiative. There is no bigger issue related to drugs than helping ensure that our patients have uninterrupted access to their life saving and life sustaining medications in this era of non-stop drug shortages.”
Kistner also noted that Vizient will regularly review these medications and others as drug therapy recommendations change. “We will continue to advocate for and endorse public policies that facilitate expanded supply of these medications, as well as focus on the development of clinical mitigation strategies for medications that are classified as essential.”