Colorado Agencies Monitoring Drug Shortage Concerns as DEA Takes Steps to Increase Production

Posted: April 7, 2020

DENVER (KDVR) – The Colorado Hospital Association and the Colorado Pharmacists Society are monitoring concerns from hospitals about the availability of drugs used to place patients on ventilators in Colorado.

“As the numbers (of COVID-19 cases) keep increasing, the concern gets higher and higher,” Emily Zadvorny, the executive director of the Colorado Pharmacists Society, said.

Sedatives and pain killers like fentanyl, hydromorphone and morphine are on the FDA shortage list, said Zadvorny. Other drugs used to help sedate and reduce pain for ventilated patients include ketamine, propofol, precedex, lorazepam and midazolam, she said.

In Colorado, “nobody has run out, per se,” said Zadvorny. “The medical and pharmacy staff (are) working together for alternatives to the standard of care. So, (we’re) looking at - can we use a different medication? Can we compound any medications? Can we use something different? But just grave concern that's there’s very limited supplies."

National organizations like the American Society of Health System Pharmacists have raised concerns about drug availability and access to federal agencies like the Drug Enforcement Administration, warning of “supplies dwindling quickly.”

A spokesperson for ASHP said the DEA has been responsive.

“Agency officials have set up a regular meeting to share information and data,” Aretha Hankinson said, explaining that the DEA has been approving Aggregate Production Quota (APQ).

Aggregate Production Quotas, according to the DEA, “represent the total amount necessary to meet the country’s medical, scientific, research, and industrial needs, lawful export requirements, and the establishment and maintenance of reserve stocks.”

The DEA announced Tuesday it would increase the 2020 APQ by 15 percent for various drugs needed to treat COVID-19. It also said it would approve increases in imports of medications necessary for patients on ventilators.

“DEA is committed to ensuring an adequate and uninterrupted supply of critical medications during this public health emergency,” Acting Administrator Uttam Dhillon said. “This will ensure that manufacturers can increase production of these important drugs, should the need arise.”

“The real call is please, please increase the production of these medications as quickly as you can and get those allocated to the most critical hospitals and the most critical areas,” Zadvorny said.

“We’re carefully watching our supply," Julie Lonborg, a representative for CHA, said.

While there are no current shortages in Colorado, Lonborg said facilities in northern Colorado, the Denver metro area, Vail and Eagle have expressed the most concern.

“And that’s consistent where the (COVID-19) hot spots are,” she said.

Lonborg said CHA has been in touch with drug manufacturers and federal legislators, requesting that the production of drugs be increased even though some of the necessary drugs are opioids.

“I think all of your viewers would recognize the effort that that we as a country have placed on reducing our dependence on opioids and all of the work that had gone into that. And that included a reduction in the production of those drugs as well,” she said. “Because of the need for those drugs during this specific event and this pandemic, we’ve actually asked the manufacturers to ramp back up the production of those things.”

Lonborg said Colorado hospitals previously established a memorandum of understanding among themselves as part of a pandemic preparedness plan. The MOU allows hospitals to share supplies, including medications.

“We also have a number of health systems in our state who are part of national health organizations, and they’re able to draw on their national organizations to try to fill any supplies,” she said.