Background and importance Medication shortages and unavailability have become a growing worldwide issue because of their possible clinical impact: reasons can be related to parallel trading (drug unavailability) or lack of production (drug shortages). When they occur, identifying a similar drug may be required or the drug is imported from abroad.

Aim and objectives The aim of the study was to perform an analysis of drug shortages (DS) and drug unavailability (DU) occurring at the centre from January 2018 to June 2019.

Material and methods The analysis included every DS and DU for every drug included in the formulary from January 2018 to June 2019. Any drug request received by the pharmacy during this time was analysed to determine DU and DS, and the drugs involved. Classification of DU or DS was performed through consultation on the DS list published by the Italian Medicines Agency. The analysis was performed for three time points: first semester 2018 (S1), second semester 2018 (S2) and first semester 2019 (S3). Also, an analysis of the medication group involved over time was performed.

Results The analysis detected DU for 19 drugs included in the formulary: S1 (2: intravenous ampicillin 1 g, ceftazidime 1 g), S2 (5: intravenous midazolam 5 mg, oxacillin 1 g, iron gluconate 62.5 mg, methylprednisolone 40 mg, glutathione 600 mg), S3 (12: intravenous piperacillin/tazobactam 2.25 g and 4.5 g, lysine acetylsalicylate 500 mg, hydrocortisone 100 mg, suxamethonium 5 mg, ceftazidime 1 g and 2 g, cefepime 2 g, glutathione 600 mg, methylprednisolone 40 mg, heparin 5000 units, atracurium 50 mg). Ten cases of DS requiring importation were found: S1 (4: mupirocin 2% nasal ointment, intravenous chlorphenamine 100 mg, alprostadil 20 µg, etilefrine 10 mg), S2 (3: intravenous diazepam 10 mg, lorazepam 4 mg, fructose 5 g), S3 (4: oral labetalol 5 mg, danazol 200 mg, sodium nitroprusside 50 mg, intravenous fructose 5 g). Medications groups involved in DU and DS were: antibiotics (31%), non-steroidal anti-inflammatory drugs (20.7%), benzodiazepine (10.4%), antihypertensive (10.4%), dietetics (10.4%), anaesthetics (6.9%), urological drugs (3.4%), antihistamines (3.4%) and adrenergic drugs (3.4%). The rate of DS did not change over time, while DU increased from S1 to S2 (+150%) and from S2 to S3 (+150%).

Conclusion and relevance While the number of DS requiring drug importation remained constant, DU strongly increased over time, leading clinicians to identify similar treatments. The analysis did not show any prevailing medication group over time.

References and/or acknowledgements No conflict of interest.