Propofol Shortage & Resources

The recently expanded recall of certain lots of propofol by Hospira, coupled with the latest announcement from Teva that it will cease further production of propofol, has led to many questions and concerns regarding propofol supplies.

The Food and Drug Administration (FDA) is aware of the difficulty many anesthesia professionals and facilities are experiencing in maintaining their propofol supplies.  According to FDA officials, the Agency continues to authorize the importation of Fresenius Propoven 1% (propofol 1%) by APP. APP is also increasing production of APP Diprivan® and generic propofol.  In addition, FDA is hopeful that Hospira will be releasing new product shortly, since the company has recently instituted manufacturing changes in an effort to alleviate previous production problems.

Anesthesia providers and facilities should still attempt to obtain propofol through their normal distribution chains.  Those who are experiencing difficulties, however, may contact APP to arrange direct shipments. Please see the following link for a “Dear Health Care Professional Letter” from APP regarding ordering information.

Order propofol directly from APP: http://www.fda.gov/downloads/Drugs/DrugSafety/DrugShortages/UCM215027.pdf

As always it is important for FDA to understand the extent of all drug shortages. Therefore, if you or your facility are experiencing difficulty obtaining any medication, please contact the FDA Drug Shortage Division to let them know.

Contact information for the FDA’s Drug Shortage Division: http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm142398.htm.

Additional information on the propofol shortage from the FDA can be found at the following website, which also contains answers to some frequently asked questions.

FDA Propofol Shortage Website: http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm207290.htm

Anesthesiology Labor Market Study 2010

Findings:

Work arrangements

  • 40% of CRNAs and ANs are employed by a single group
  • 40% of CRNAS and ANs are employed by a single facility or hospital
  • ANs spend more time performing general anesthesia
  • CRNAs spend more of their time performing monitored anesthesia care (MAC)
  • CRNAs are more likely to be employed by rural facilities

Reimbursement

  • ANs work more hours and make twice as much as CRNAs
  • Both ANs and CRNAs make more money in a rural setting

Regional Differences

  • Western CRNAs are least likely to be employed by a group
  • Western ANs are most likely to be employed by a group
  • Northeastern ANs and CRNAs tend to work in larger facilities

Shortage/Surplus

  • Greatest evidence for a shortage is in the Northeast and in urban areas
  • Nationally, the anesthesia market is thought to be equilibrium, while states see mixed statuses
  • 25 states show a shortage of ANs currently
  • 19 states show a shortage of CRNAs currently
  • In absolute numbers, Florida, Alabama and North Carolina exhibit the most shortage of ANs
  • In absolute numbers, Pennsylvania, Michigan and Florida exhibit the greatest shortage, while Minnesota, North Carolina and California exhibit the most surplus of CRNAs.
  • 2020 national projections exhibit a shortage of ANs and a surplus of CRNAs.  

Rand Health performed this study in 2010 for Ethicon. For copy right reasons I am providing my impression of  the most pertinent findings of the report and not a copy of the reoprt. If you would like a reprint fo the actual report you can request one at http://www.rand.org/pubs/technical_reports/TR688/