The survey on drug shortages was carried out on more than 1,800 healthcare practitioners (68% pharmacists) during July–September 2010.

Respondents found conditions associated with drug shortages during the past year to be the worst ever and were perplexed as to why the US is experiencing drug shortages of a proportion that is often associated with third-world countries.

The main difficulties encountered by pharmacists and other healthcare practitioners included a lack of available information, lack of advanced warning, no information on the cause, trouble finding alternatives and risk of adverse patient outcomes.

Shortages occur for a host of reasons, including the unavailability of raw ingredients, FDA enforcement actions that halt production, voluntary recalls, poor inventory ordering and changes in product formulation.

Most of the medications experiencing shortages are sterile injectibles and are generic. When a decrease in the number of companies making an older, less profitable drug is coupled with problems in manufacturing, shortages occur and that seems to be what is happening right now in the US.

The number of shortages experienced, however, in the past few months is unprecedented, particularly with high use medications, including emergency drugs, pain medications and anaesthetic agents.

Mr Michael Cohen, President of the ISMP, says that this is a safety issue, because substituting different strengths or different products for drugs that are not available “increases the potential for errors”.

The ISMP is a non-profit organisation devoted to medication error prevention and safe medication use.