“While there is no magic bullet, there are some strategies that might help mitigate the gap of needs versus supply,” says Sheldon Sones, president of Sheldon Sones and Associates in Newington, Connecticut. “Our concerns in wake of the disasters evolving in Puerto Rico focus on intravenous solutions as well as frequently used antibiotics such as cefazolin.”
One of the best ways for an ASC to manage a drug shortage is to take steps to prepare when no shortages exist, Sones says. As a first step he recommends cultivating good relationships.
“I have suggested to our facilities throughout the year, as we have experienced intermittent shortages of routinely-used drugs and solutions, to establish relationships with several wholesalers,” he says. “These should be active relationships and not activated during shortages solely. Relationships that are used in that manner are generally unsuccessful.”
Rochele Hovasse, chief operating officer of Audubon Surgery Center and Audubon ASC in St. Francis, Colorado Springs, suggests having good relations with local hospitals and pharmacies as well.
“We have a strong relationship with our local hospital, so if we go low on a certain drug, the hospital shares it with us because the hospital gets its supplies before the ASCs do,” she says. “We also have good relations with our distributor and vendor. Our distributor representative gave us a warning about the possible shortages. So, as soon as Hurricane Maria even started tracking, we could place a large order of inner stem implants for our urology division. Our vendors also are in constant contact with the manufacturers, and they gather information and let us know about possible shortages. We reach out to them as well.”
Darlene Vortherms, chief executive officer of PurNet Inc. of Worthington, Minnesota, says her company notifies its more than 2,000 members as soon as it gets notification of a possible shortage from the big industries.
“We work with many distributors,” she says. “When our members cannot get their supplies that they have already placed orders on, we shop for them. We even go through other distributors that are not our main distributor.” Given that her company has no contract pricing with those other distributors, price gouging could occur, she says.
As a second pre-emptive measure, Vortherms suggests stocking up. Hovasse says she balances her ASC’s inventory and stock levels all through the year. “It is a juggle. We prepare for the winter in Colorado,” she says. “Monument Hill [a mountain pass in central Colorado] can shut down because of weather, so for spike seasons, we overstock for seasonal products. Look at your case mix to determine the level and the types of stock you should have on hand.”