How do the drug and health care industries plan to provide prescription drugs during a disaster

The prescription drug industry is a complex, interdependent system that relies on many separate entities to achieve a successful outcome: insurers to authorize benefits, providers to write prescriptions, pharmacists to fill and carry medications, wholesalers to deliver supplies, governments to legislate quality, and consumers to understand and navigate this process. Under routine circumstances, each stakeholder functions as an independent link in the drug delivery process, but in community-wide disasters these links can become disjointed with insurmountable barriers arising that can keep patients from getting needed medications. The challenge then is to recognize these barriers preemptively and develop strategies that foster stakeholder collaboration for routine and disaster prescription drug practices. This study assessed internal planning mechanisms of industry stakeholders (insurers, pharmacists, clinicians, government, consumers) serving the Los Angeles area. Key informant interviews and focus groups were conducted to identify what feasible, systematic strategies were implemented (and contemplated) to ensure patients' access to prescription medications during routine, emergency, and disaster situations. Qualitative analysis revealed similarities in stakeholders' expectations about each others' emergency roles in the prescription drug delivery chain and decision-making in activating emergency prescription drug services. Differences existed among stakeholders' perceived responsibility to provide and fund emergency medication supplies, willingness to collaborate with other stakeholders/competitors in a disaster, and internal continuity-of-service preparedness strategies. While our findings show that Los Angeles prescription drug stakeholders experience success and challenge in both routine and disaster situations, system-wide solutions are feasible to reduce existing borders, coordinate efforts, and enhance preparedness for prescription drug disaster efforts.