FF Procurement Tech

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SharePoint Discussion Board Use in Pharmaceutical Shortages Management Category: Enhance WorkflowRobert Malmstrom, PharmD, Jennifer Kryskalla, PharmD Veterans Affairs Northern California Health Care System, Mather CA Background Introduction Discussion Board Screenshots Results • Currently, record number of drug shortages and FDA expects shortage problem to worsen • Critical products affected: • chemotherapy, acute care meds, analgesics • Safety impact over 12 months: • 1,000 near misses, errors, adverse outcomes, deaths • U.S. financial impact: • 1 - 2% annual drug budget variation  $5 billion/year • $700 million/year for personnel costs dealing with shortages • Discussion Boards create a place for newsgroup-style discussions, quickly disseminating relevant information • All VA health care systems have access to a SharePoint site, allowing for creation of a drug shortage discussion board • Discussion board implementation requires site owner(s), participant training, and advertising to promote use • Pharmaceutical shortages posted in 1st 30 days: 28 • Drug shortage-related email reduction: 52% • Additional shortage-related postings: • American Regent plant closure updates allowing technicians to plan injectable product procurement Lead Procurement Tech P’econ Pharmacist Vendor Shortage Vendor Shortage Shortage Management: Before • Discussion board accessible to all pharmacy staff • Posts limited to P’econ Pharmacist & procurement techs Shortage discussion board Vendor Shortage Vendor Shortage • Members post shortages as discovered • Format allows easy update tracking & most recent news FF Procurement Tech Figure 1. Drug shortages 2005 – 2010 Source: Drug Shortage Program, Center for Drug Evaluation and Research. Excludes vaccines, immune globulin and biologic products Lead Procurement Tech Discussion Vendor Shortage Vendor Shortage P’econ Pharmacist Vendor Shortage Lead Procurement Tech • Inefficient older drug shortage procedures lead to: • Missed purchasing opportunities • Over-purchasing, leading to waste • Communication gaps and misunderstandings • With discussion board use for drug shortage management, VANCHCS achieved: • Reduced cost from 3rd party vendor purchases • Faster procurement time • Discussion boards applicable to multi-site health care systems and individual sites • Dismal outlook for future industry supply • Shortage reasons: • manufacturing difficulties industry consolidation • increased regulation increased demand • discontinued products few sterile IV manufacturers raw material globalization Lead Procurement Tech Mather Procurement Tech FF Procurement Tech Figure 3. Technicians email pharmacoeconomics (p’econ) pharmacist or lead procurement technician, who research shortages and reply to the requesting technician via email. Information may not be shared with other procurement techs/back ups, and email messages may be delayed, repeated or buried among other messages. Lamotrigine 200mg tablets 0 California • VA Northern California Health Care System (VANCHCS) consists of 10 drug ordering sites, adding barriers to managing shortages • Complicated communication • Requires greater patient coverage • Short supply products are purchased quickly, depleting stock within minutes or hours P’econ Pharmacist Lead Procurement Tech Individual replies for each topic Shortage Management: After Vendor Shortage Vendor Shortage Lead Procurement Tech Lamotrigine 200mg tablets CMOP currently stocks brand only and only non-contracted generics are available.  Bill in FF said he has about 1400 tablets available as of 5-2-2011.  If you are out and cannot get any, please forward labels to TP5 until further notice. Conclusion Fairfield is out of medication- no more labels please. • Implementing discussion board in drug shortage management: • Increases efficiency for pharmacists and technicians handling pharmaceutical shortages • Decreases waste • Results in fewer VANCHCS drug outages • Decreases therapy interruptions • Decreases cost and improves patient care • Decreases time spent coordinating shortages P’econ Pharmacist Figure 2. VANCHCS Sites. Map Key: FF Procurement Tech Pacific Ocean Vendor Shortage Vendor Shortage McKesson has >100 in stock of the Taro brand lamotrigine tablets. The item # is 3268034. Vendor Shortage Objectives Lead Procurement Tech References Vendor Shortage • Coordinate pharmaceutical shortage management in efficient and cost-effective manner • Prevent interruptions in patient pharmacotherapy and adverse events related to drug shortages Vendor Shortage 1. http://money.cnn.com/2011/06/10/news/economy/drug_shortages_fda/index.htm 2. Drug shortages: National survey reveals high level of frustration, low level of safety. ISMP Medication Safety Alert: 9/23/2010 – Vol. 15 No. 19 3. Choudhary et al. PPP Magazine: February 2011 - Vol. 8 No. 2 - Pg 8 4. Stewart K. Health facilities on guard over drug shortages. Salt Lake Tribune: 1/31/11 Figure 4. Using the discussion board, pharmacoeconomics pharmacist and procurement technicians instantaneously share information with all relevant parties.