Drug-supply shortage hitting home

Affect on Steamboat hasn't been as pronounced as other towns around state

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— Pharmaceutical production shutdowns are have caused drug shortages for doctors in hospitals throughout the state, including some in Steamboat Springs.

Many serious surgeries have been postponed because of the shortage, which has been blamed on several factors: the cost and availability of raw materials and the increasing number of new drugs.

"We have had some sporadic shortages in a number of areas," said Gary Haberlan, pharmacist at Yampa Valley Medical Center. "It's been much more pronounced in the last six months, also in the latter part of last year."

Haberlan said the shortage has mostly affected the supply of injectable steroids and narcotics but that modifications have been made. There are often substitutes available for the most scarce drugs.

"We have been able to anticipate our need so we have not compromised patient care," Haberlan said.

Dr. Brian Siegel of the Elk River Anesthesiology Association said he has felt the brunt of the shortage, particularly in painkilling and anesthetic drugs. Siegel works with three primary steroids used to treat people in pain: celestone, triamcinolone and methyl-prednisolone.

There is little or no supply of the first two, he said, and the methyl-prednisolone, which there is a supply of, is a steroid that has limited uses.

"It definitely has a drawback in that it's limited the type of procedures I can do," Siegel said. "It's certainly a problem."

Methyl-prednisolone has small particles, which would raise safety concerns when used in areas close to the brain stem, Siegel said. Instead, he's had to go the long way around on procedures requiring that drug, just to ensure patient safety.

"The drug shortage has impacted our agency as well," said Sue Birch of the Visiting Nurse Association. "We are having to screen patients that would need tetanus infections and prioritize who receives that, because there is a limited vaccine."

Birch said the association's flu shot fee is likely to double because of the new costs of vaccines as well as a new law requiring the use of expensive retractable syringes. She advised employers to be aware and budget accordingly.

"As far as supply, we have been pretty fortunate," Birch said. "We are similar to a health department in that we have kind of governmental status priority."

Birch said the agency has been monitoring its supply to avoid problems.

"We've felt it somewhat, but it's nothing serious," said Wendy Lyon, pharmacist at Lyon's Corner Drug and Soda Fountain. "Fortunately, for most of the prescription drugs, there's always something similar. There hasn't been one unique entity that can't be replaced."

Lyon's, as well as other area pharmacies, did note a shortage in generic inhalers. Albuterol is the more cost-efficient version of Ventolin and Proventil, both of which are in better supply. Lyon said it has been a year-long problem, probably triggered by a massive recall earlier in the year.

"They're very aware," said Haberlan of supplier Cardinal Health's sense of the situation. Haberlan said that communication with manufacturers and wholesalers is key in managing drug supplies.

"I think it's going to be a long-term challenge," said Haberlan. "I'm hopeful that we're going to be able to stay ahead of the game by keeping our medical staff informed. I'm not anticipating any compromises to patient care."

"It has not been a serious problem that affected patients or health care," Lyon said. "I think people in Steamboat have been able to get what they need. Maybe we've just been lucky."

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