16 drugs vulnerable to shortages after US drug company closed

Sixteen drugs have a high risk of supply disruption after an Illinois drugmaker ceased all operations in February, according to a March 15 report from the End Drug Shortages Alliance. 

Gurnee, Ill.-based Akorn Operating Co. filed for bankruptcy, laid off hundreds and closed its plants on Feb. 23. In the weeks after, a ripple of drug shortages may be coming, such as liquid albuterol

The End Drug Shortages Alliance includes Vizient, the American Society of Health-System Pharmacists and the Children's Hospital Association. Vizient, a consulting firm, compiled a market analysis of Akorn's 100-plus products and found 16 that are most vulnerable to a shortage based on the supplier market share and the United States Pharmacopoeia impact score. 

Four of them are essential medications, including adenosine, which treats supraventricular tachycardia; calcitriol, which manages hyperparathyroidism in patients undergoing renal dialysis; dimercaprol, a metal poisoning antidote; and physostigmine, which is used in the reversal of anticholinergic syndrome.

At the end of the report, the alliance details mitigation strategies for some of Akorn's products.

Here are the 16 drugs to watch:

Drug

Akorn's market share (percentage)

Currently in shortage

Has a mitigation strategy

Vulnerability score (percentage)

Adenosine injection

38

N

Y

68.4

Alfentanil 

hydrochloride injection

100

N

N

Not reported (NR)

Calcitriol injection

100

N

Y

82.4

Cyclopentolate ophthalmic

35

N

N

89.2

Dimercaprol injection

100

N

Y

28.6

Fluorescein injection

82

N

Y

NR

Hydroxyamphetamine 

and tropicamide ophthalmic

100

N

N

NR

Levofloxacin ophthalmic 

100

N

N

6.6

Lidocaine HCl 2% 

topical (mouth/throat) 

solution

46

N

N

58.2

Methadone injection

51

N

N

68.6

Phenylephrine ophthalmic

90

N

N

2.3

Physostigmine injection

100

N

Y

88.4

Sufentanil injection

79

Y

N

81.8

Orphenadrine injection

75

N

N

57.1

Tetracaine injection

99

N

Y

7.3

Tropicamide ophthalmic

33

Y

N

89.9

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