Demand for Cardiovascular Drugs Increases as COVID-19 Cases Soar

Premier Inc recently found that drug shortages to treat cardiovascular conditions have increased due to the COVID-19 pandemic, according to a press release. 

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One of the leading healthcare company’s found that between 40 and 50 percent of COVID-19 hospitalized patients have some form of cardiovascular disease. This makes them more susceptible to arrhythmias, heart attacks, and septic shock. 

Premier data showed that demand for amiodarone, a drug used to decrease the risk of late onset cardiac arrest and manage arrhythmia, increased 66 percent nationally in the first quarter of 2020.

Two vital drugs to manage septic shock, norepinephrine and vasopressin, were also in higher demand, with orders rising by 122 percent and 66 percent, respectively. New York, a hotspot for COVID-19, has seen demand for amiodarone more than double the national average at over 152 percent and demand for norepinephrine by 421 percent. 

Researchers noted that orders for most drugs, aside from norepinephrine, were able to be fulfilled. Norepinephrine has a monthly fill rate of 55 percent in New York, so nearly half of the orders were able to be supplied. 

The drug has historically been in short supply and low fill rates of norepinephrine have been linked to a 3.7 percent increase in patient mortality and $13.7 billion in losses to the healthcare system. A healthy fill rate is considered to be 80 percent or higher, Premier stated.

“For the most part, our data shows supply has been able to keep up with demand for these drugs and we have not seen widespread shortages – but we were very lucky,” Michael J. Alkire, president of Premier said in the press release.

“Drugs such as amiodarone and norepinephrine were problematic even before COVID-19, rolling on and off the FDA drug shortage list for years. Now is the time for the country to act proactively to ensure drugs needed to treat these conditions are available in abundance, and that we don’t incur shortages should demand increase again with a resurgence of disease.”

The data also showed that between 25 and 40 percent of hospitalized COVID-19 patients develop blood clots. The demand for anti-clotting medication, enoxaparin, has increased by 46 percent in the first quarter of 2020 when compared to the same period last year. 

“Considering the increase in demand for drugs associated with COVID-19, Premier is working to ensure that the supply of these products is protected and readily available should cases spread to other communities,” Premier said. 

Premier recommended measures specific to the drugs used for co-morbid conditions, including that the drugs should be added to the Strategic National Stockpile (SNS) and a minimum 90-day supply be maintained based upon utilization in hotspots such as New York. 

Additionally, FDA should ensure at least three manufacturers of active pharmaceutical ingredients (API) and at least three manufacturers of finished dose form (FDF) for each of the drugs. 

Additional recommendations from the healthcare improvement company included: 

• At least one API and at least one FDF should be domestic
• Manufacturers of these drugs should work proactively with organizations to demand and increase capacity/supply to avoid shortages 
• FDA should proactively expand its temporary guidance for its drugs eligible to be compounded to include amiodarone to allow for surge capacity
• Distributors should work with organizations such as Premier to create a dynamic allocation system that accounts for surge demand and prioritizes the needs of acute care providers

“For commodity products, we can tap adjacent industries to begin production, but drug manufacturing is highly regulated, and it typically takes years and investment to build additional capacity and gain FDA approval,” Alkire said. 

“Even with an expedited approval process, manufacturers will not be able to produce pharmaceuticals in greater quantities overnight, which is why we need action today. Taking these steps now will ensure that we don’t run into shortages later for some of our most critical medications providing treatments to our most vulnerable citizens.”