Back orders and, Discontinuations and, Allocations oh my. Presentation by Elaine Brick

Transcription

1 Back orders and, Discontinuations and, Allocations oh my Presentation by Elaine Brick

2 Who am I? So many adjectives, so little time. Many, many, many purchase orders later.

3 How Did This All Start: Drug shortages have been an issue for the last 2 years in our profession. Apotex had major production issues that affected numerous products from their line. In February this year, the issue came to the forefront when the main supplier of our IV products, Sandoz announced a slow down in production at their Boucherville plant. Efforts were made to obtain drug products from other manufacturers. The problem became even bigger when other drug companies started to have shortages as well because of the increased demand. To deal with the shortages, many of the drug companies introduced allocation procedures to disperse medications evenly throughout the region.

4 What to Do? WRHA recognized that a team of staff would be needed to: Collect information regionally about quantities and in some cases expiry dates of stock on hand. Collect information regionally about usage of shorted products. Maintain comprehensive data to be used for vital decision making. Create controls of how much product is being dispensed to prevent hoarding and inappropriate usage.

5 Monitor allocations ordered and received to ensure proper influx of products throughout the region. Investigate what other products could be used in place of short stock (clinical recommendations). Communicate such changes as needed throughout the region. Provide direction and co-ordination for site to site sharing of drug stock. Continually look for alternate sources for product. Monitor all manufacturer's expected release dates

6 Collecting The Information: The first spreadsheet was created 2 years ago to manage the alternates for back ordered products. It has grown considerably since then and became a daily reference for the team when the Sandoz crisis hit this spring. Legend: Blue Font - New, Additions New Red Font: Critical, Weekly Green Font: me (update), New Critical, Drug Product (Generic Name/Strength ) Contra cted Item Yes/No Contract Item # Manufact urer B/O, Dc'd, Recalll, Allocation Inventory Communications (Fiscal Year April 1, 2012 to March 31, 2013) Date Reported St ep 1 Sit e Reporting Last Update 06/07/2012 Expected Release Date Acetylcysteine 200 mg/ml 30 ml vial Yes Sandoz Allocation 27-Feb-12 Concordia Unknown No Step 2 - MB Formulary Approved Alternate MB Formular y Intercha ngeable Productyes or no Product Details Alternate Details Current plan Product on antidote list. Starter therapy of 3 vials. Full therapy 4 vials. Continue ordering allotment from Sandoz. Seven Oaks has ordered 500 vials of Alveda Mar 1/12. Sites to order from Seven Oaks. Approved Alternate Product and product details Alveda and Wellspring products are interchangea ble. Date Backorder is Resolved Aminophylline 25 mg/ml inj (10 ml) Yes Hospira B/O 8-Mar-12 GGH 31-Jul-12 No Aminophylline 25 mg/ml inj (20 ml) Yes Hospira B/O 8-Mar-12 GGH 31-Jul-12 No Amiodarone 50 mg/ml 3 ml injection Yes Sandoz Allocation 1-Mar-12 SOGH Unknown No PPC available from HP # on B/O Omega is a reasonable alternative, however percentage of theophylline is different. See clinical memo previously distributed. Adjustments may be required. Omega from CPDN 25 mg/ml 10 ml # B/O expected release July 6. Sites to continue to share reg No other supplier of 20 ml. Use the alternate 10 ml as listed above Teva currently not available. Hospira brand not in production. PPC product on allocation to contracted customers only. Omega is a reasonable alternative for the Hospira product PPC and Teva are interchangea ble with Sandoz

7 One of the spreadsheets developed displays quantity on hand and usage for regional sites. Some sites provide a physical count once a week while others have the data available electronically that gets pulled directly from the Centricity system. WRHA Stock Status Reports Usage Values reflect monthly MB Health Request Legend: 1-7 days WRHA Request 8-14 days Long Term B/O day Do Not order this week Concordia Deer Lodge Grace Riverview Seven Oaks St. Boniface Victoria Regional Totals Generic Drug Monthly Average Average Weekly # Days Name Strength Form Date QOH Usage QOH Usage QOH Usage QOH Usage QOH Usage QOH Usage QOH Usage QOH Usage Usage Supply 2 mg/ml 1 ml injection June 12/ ml injection June 12/ Hydromorphone 10 mg/ml 5 ml injection June 12/ ml injection June 12/ mg/ml 1 ml injection June 12/ Hydroxyzine 50 mg/ml 1 ml vial May 15/ Hyoscine Butylbr 20 mg/ml 1 ml amp June 12/ Iron dextran 2 ml vial May 7/ mg/ml (Infufer) 5 ml vial May 7/ Isoproterenol 1 ml amp May 22/ mg/ml HCl 5 ml amp May 22/ ml injection June 12/ mg/ml 20 ml injection June 12/ Ketamine 2 ml injection June 12/ mg/ml 10 ml injection June 12/ ml injection June 12/ Ketorolac 30 mg/ml 1 ml injection June 12/

8 Comparing Allocations, Receivals and Usage For Week of May 29 - June 4 Sandoz Allotment units MDP # Generic Drug Name Strength Form WRHA Weekly Usage Sandoz % Allotment Allotment Received asssigned Units Acetylcysteine 200 mg/ml 10 ml vial % ml vial % Alcohol (Dehydrated) 100% 10 ml 8 100% Amikan SO4 250 mg/ml 2 ml vial 9 100% ml vial % ml vial 0 100% 0 0 Amiodarone HCl mg/ml 6 ml vial % ml vial 0 100% Atracurium Bes 10 mg/ml 10 ml vial 17Long Term B/O ml vial 33 75% mg/ml Atropine SO4 1 ml amp % mg/ml 1 ml amp % mg/ml 1 ml amp #N/A Long Term B/O Aurothiomalate Na 25 mg/ml 1 ml amp #N/A 75% mg/ml 1 ml amp #N/A 75% ml vial 77Long Term B/O 0 0 Betamethasone (Betaject) 6 mg/ml ml vial 6Long Term B/O Bretylium Tos 50 mg/ml 10 ml vial 1 100% ml vial % ml vial % Clindamycin 150 mg/ml 6 ml vial 0 100% ml via 0Long Term B/O ml vial % 24 24

9 Tools The collection of spreadsheets created are designed to be tools to assist the back order team, Technician Managers and Purchasing Technicians. Each has a different function, but they work together to create a database of information. A sharepoint location was created to house all of these files. This allows access to the data for all members of the distribution team at all times.

10 Oh how things have changed. The challenges we have faced and continue to meet have shown the need to change how we look at our inventory management. We have needed to look at our drug inventory not as each site s stock but as a regional pool, shared between all the hospitals. Many people have pulled together to ensure that drug product was in the right place for the patient needs. Although we have developed methods to cope, the situation is not clear yet. The company reports many products are or soon will be off production until sometime next year. Alternate manufacturers are ramping up their production line in an attempt to compensate. Some alternate contracts have come into place. The work continues and together we can get it done!

11 QUESTIONS?