“In the midst of every crisis, lies great opportunity.” — Albert Einstein
The shortage of key cancer treatment drugs carboplatin and cisplatin made national headlines in recent weeks, as hospitals implemented multiple strategies to maintain care for their patients when supply of these two drugs was remarkably low to nonexistent. While this shortage deservedly caught the attention of the nation, hospitals must navigate dozens to hundreds of drug shortages every day. This shortage is a worst-case example of how inefficiencies in the pharmaceutical supply chain can have devasting impacts on patient care.
Unfortunately, hospitals far too often must manage short supply of drugs, seek alternative sources for drugs, adjust treatment regimens and collaborate with other health systems to maximize supply. Hospitals throughout the state used all these tactics to respond to the recent crisis.
I’m proud the MHA was able to quickly raise the flag on this issue to our lawmakers as soon as we became aware of it. U.S. Senator Gary Peters (D-Bloomfield Twp.) chairs the Senate Committee on Homeland Security & Governmental Affairs and has prioritized drug shortages as a national security concern. His report from March 2023 shares a wealth of information on the subject, including all the problems associated with drug shortages and recommended solutions. His committee has been a key partner in providing accurate information about the shortage to Michigan hospitals.
In addition, U.S. Representatives Debbie Dingell (D-Ann Arbor) and Tim Walberg (R-Tipton) led Michigan’s US House delegation in sending a bipartisan letter May 24 to Food and Drug Administration (FDA) Commissioner Dr. Robert Califf to take immediate action to mitigate the effects of the nationwide shortage. I’m happy to share every member of our House delegation signed on to the letter, showing the health of our hospitals, patients and communities is truly a bipartisan issue.
Our work will continue on this issue far after the supply of these two drugs stabilizes, as the MHA supports several strategies that will address drug shortages. The first is relaxing prior authorization requirements from health insurers for alternative therapies during a shortage so they can be used widely. Federally, we believe establishing an early warning system will help avoid or minimize drug shortages so both manufacturers and providers have more time to respond to an upcoming shortage. Healthcare providers also welcome improved communication from the FDA and drug manufacturers, as there is often little to no transparency on the cause of a drug shortage. Lastly, changing the economic model to encourage drug manufacturers to stay in, re-enter or initially enter the market would be beneficial to all stakeholders. Many shortages occur with generic drugs due to a limited number of drug manufacturers.
In addition to the public policy arena, it is noteworthy that hospitals across the country – including several of our MHA members – helped to launch Civica, an entity that is helping to increase the production and availability of key generic drugs. While not directly applicable to the current cancer drug shortage at this time, this effort is an example of the field looking to the future and doing all we can to ensure appropriate healthcare access to patients.
Finally, I’d like to lift up the MHA’s response to this crisis as a great example of the value of an association. Since we represent all acute care community hospitals in Michigan, we’re able to speak with a unified voice. The MHA has the relationships and institutional knowledge to quickly convene ad hoc groups in times of crisis to gather knowledge on the subject and what needs to be done, and then can execute and utilize our long-standing partnerships with lawmakers, both at the state and federal levels, to generate necessary awareness and action. By looking at national headlines, Michigan has been a leader in the shortage of carboplatin and cisplatin. That’s a testament to the health of our association and the culture we have helped to establish, whereby safety and quality engender collaboration and not competition within our hospital and health system membership.
As always, I welcome your thoughts.