Drug shortages may affect the quality of patient care and treatment options. Even alternative products are available, they may cause other problems, such as different efficacy and side effects or the potential for medical errors due to unfamiliar with alternative products. They also increase costs to hospitals and health care systems, and pose a great influence to the public’s health.
The Taiwan Food and Drug Administration (TFDA) has authorised the Taiwan Society of Health-System Pharmacists to conduct the relevant projects since 2011. The purpose of this project is to establish a multidisciplinary management flowchart to aid government agencies, health care institutions, pharmaceutical manufacturers, and pharmacist and pharmaceutical societies and associations in handling drug shortages. This project comprises seven phases: establishment of an online Taiwan drug supply database platform, stipulation of strategic plans for drug shortages, proposal for a Taiwan Essential Medication List, creation of an emergency inventory liaison network, committee and pharmacist consensus meetings to ensure internal consistency during evaluation, educational forums for pharmacists, and establishment of a cross-department communication team for special cases. Through these measures, impact from drug shortages can be relieved and patient safety in Taiwan can be improved greatly.
The task force covers the northern, central, eastern, and southern regions of Taiwan and contains approximately 60 members, including pharmacy directors, clinical pharmacists, and specialised drug supply pharmacists from seven medical centers, namely Taipei Veterans General Hospital, National Taiwan University Hospital, Shin Kong Wu Ho-Su Memorial Hospital, Chang Gung Memorial Hospital (Linkou and Kaohsiung Branches), China Medical University Hospital, and Hualien Tzu Chi Hospital. Project assistants monitor Taiwan drug supply database platform and global drug shortage information. When the drug supply database platform receives the drug shortage report, the review and verification process is initiated. Pharmacists at seven medical centers are assigned to initially review the report, confirm drug supplies in the real world, and further evaluate possible drug substitutes according to generic names, dosage form, strength, and indication. Other information, including urgency levels and clinical suggestions, is still required. If no substitute is available and the drug in short supply is required for clinical practice, the TFDA engage in drug shortage management to check the inventory and seek public suppliers or special import availability. If necessary, the TFDA discusses management strategies with relevant units, such as the National Health Insurance Administration (NHIA) or Department of medical affairs, Ministry of Health and Welfare (MOHW).
When drug shortages occur, we may need to use alternative products. No matter they are brand or generic drugs, the TFDA will monitor drug quality strictly. Healthcare professionals should remind patients to take medication regularly and keep a positive attitude when discussing with patients.
Figure. Taiwan drug supply database platform