Drug Shortages After the Eastern Japan Earthquake: Experiences in a Tertiary Referral Center

The large earthquake in eastern Japan on March 11, 2011, caused a nationwide drug shortage. The authors investigated the reasons behind the drug shortage and its impacts on clinical practice in a tertiary referral center. From the day the earthquake occurred until September 11, the authors identified shortages of 26 items (2.6% of all drugs in their hospital). The primary shortage causes included the destruction of pharmaceutical plants (n = 24) and packaging factories (n = 1) and a production shift toward other items (n = 1). The nuclear accident at the Fukushima Daiichi nuclear power plant was associated with shortages of 2 items. During the 6-month study period, drug supply of 6 items recovered, alternatives were introduced for 2 items, and prescriptions were restricted for the remaining 3 items. Recoveries were achieved through the repair of damaged factories (n = 18), importation from foreign countries (n = 2), and production in alternate existing factories (n = 1). Physicians avoided long-term prescriptions of all 11 items, and substituted 4 items with similar brand agents, with the informed consent of patients. Although large-scale disasters inevitably cause drug shortages across broad areas even in developed countries, these shortages can be minimized by the coordinated efforts of clinicians and patients.