In ICUs, oncology wards, and even community pharmacies, drug shortages are no longer rare, they’re routine.
When the last vial of a life-saving injectable arrives and you have three equally deserving patients, what guides your next move:
Clinical severity?
First-come, first-served?
Long-term outcomes?
Age or quality-adjusted life expectancy?
My question is should pharmacists have a more detailed role in ethical allocation committees?
I believe age can be a relevant factor in such critical situations, as younger patients may have the potential for a longer life ahead if treatment is provided. However, this should not be the sole criterion. Any decision involving life saving drug allocation must be guided by established ethical frameworks, clinical judgement, and transparency. It’s essential that families are involved in these discussions whenever possible, ensuring transparency, empathy and communication. Pharmacists, with their deep understanding of medications and patient care, should indeed have a more active role in ethical allocation committees to support fair and informed decisions.
According to me Clinical severity condition should be treated. But every situation is different and should be handled carefully.
Yes, Pharmacists should have a more detailed role in ethical allocation committees. Pharmacists must have appropriate knowledge of medications and patient care to deal with such situations,showing concern and empathy to the patient.
Definitely. I think pharmacists will play a very crucial role here as they are the ones who are in charge of drug distribution. They should be well trained regarding how to make the ethical decisions at the time of urgency or drug shortage. I feel, it’s difficult to make a concrete and similar type of decision about who gets the injectable in various cases, as every situation/case should be looked at closely and carefully. But mostly, it goes to the patient who’s in need of it urgently based upon the severity of the condition and where the probability of prognosis is high so that the drug utilization has a value. First-come first-served when urgency is not there is the first option to get eliminated. In case of clinical severity, if the disease prognosis is very less, that comes as a highlight . And QALE alone is hardly taken into consideration in cases like this.
Yes, I strongly feel pharmacists should be part of such ethical allocation decisions. They don’t just dispense medicines they understand availability, alternatives, patient needs, and treatment outcomes deeply. When a drug is in shortage, it’s not just about giving or not giving, it’s about balancing fairness, urgency, and impact. Pharmacists can bring that practical insight and compassion both. And especially during shortages, their input can make a huge difference in saving lives responsibly.
The insights provided in this comment section is very worth it. Thank you for such wonderful and thoughtful replies.
Clinical Severity should be treated first.