(COLORADO) — After one of the major suppliers of albuterol shut down operations in February, local health experts are concerned about what this could mean for future supply shortages.

Albuterol treats respiratory diseases, such as asthma. It is also used to treat viral illnesses, like RSV, Influenza, or Covid-19. With Akorn Pharmaceuticals shutting down operations, it’s expected that current albuterol shortages will only continue to worsen.

“We’re really concerned,” said Anna Legreid Dopp, PharmD, Senior Director of Clinical Guidelines and Quality Improvement for the American Society of Health-System Pharmacists (ASHP). “This has been an unstable supply for a couple of years now due to demand with the pandemic and respiratory outbreaks.”

There are some alternatives that can be considered.

“One option would be to use the albuterol metered dose inhaler with a spacer as an alternative to the nebulized solution that’s on shortage, or to switch to an alternative agent that can dilate those airways,” said Dr. Legreid Dopp.

It’s important however that relying on the alternatives does not cause a secondary shortage.

“Making sure that we’re not seeing any hoarding happening where institutions might be compelled to order as much as they can, versus as much as they need, and then that makes the supply even more constrained,” warned Dr. Legreid Dopp.

Benjamin Turner, the Inpatient Pharmacy Purchasing Manager for the UCHealth University of Colorado Hospital (UCH) said, it has been trending toward a shortage of the albuterol liquid for quite some time now, and supply disruptions apparently started with the 20 mL bottles.

Turner echoed the warning from Dr. Legreid Dopp and said these shortages tend to have a trickle-down effect.

“You see one medication go on backorder and usually there is a substitute, so people overorder on the substitute, and then the substitute usually goes on backorder,” stated Turner.

The current concern, according to Turner, is for the albuterol metered dose inhalers.

“Hospitals hoard; they want to take care of their patients and they want to have enough medications to do that; it’s not like they are trying to be malicious about it, they are just trying to look out for their patients and do what is best for them,” said Turner.

UCHealth, which includes 12 hospitals across Colorado is doing well so far, despite the shortage.

“We’re managing our supplies, we’re not hoarding, we’re managing to get in exactly what we need, but I know this could always change a week from now,” said Turner.

Turner said the concern is, that every hospital in America uses albuterol.

“So whenever you have a drug that is this important and this widely used, it makes shortages prolong a little longer than you would normally expect, just because it is very, very hard in the beginning just to keep up with the needs of all the hospitals around the country,” stated Turner.

Currently, ASHP is monitoring more than 230 medication shortages, which in turn, according to Dr. Legreid Dopp, causes hospitals to spend hundreds of millions of dollars every year, just to manage medication shortages, in addition to millions of worker hours.

“Think about the time that Benjamin is spending trying to manage this particular shortage, so there is a lot of collateral damage here, not to mention at the end there is a patient being impacted and their health care outcomes are being compromised because of it,” said Dr. Legreid Dopp.

According to NewsNation, Akorn Pharmaceuticals shut down operations as part of Chapter 7 bankruptcy proceedings. “The company had previously been found to have manufacturing violations at its Illinois and New Jersey factories,” stated a recent article.