This fall, patients at Intermountain Riverton Hospital became the first in the nation to receive a medication produced by Civica Rx, a new, not-for-profit generic drug company created to address a shortage of vital drugs used in U.S. hospitals. It is a major milestone for hospitals to be able to purchase medications from a not-for-profit company. And the benefits for patients in Utah will soon be realized in other states as other participating hospitals and health systems begin to use drugs manufactured by the Utah-based Civica Rx.
In recent decades, shortages of vital generic drugs in American hospitals have become commonplace. The U.S. Food and Drug Administration, or FDA, reported in 2018 that drug shortages are increasing and the shortages are lasting longer — with more than 10 drugs being in short supply for five years or more. Nearly 30 generic medications have been in short supply for at least two years. The five longest shortages have lasted more than eight years.
Some Americans expect politicians to fix issues like this. The competing chants of “Repeal Obamacare” and “Medicare For All” represent the vastly different opinions about how to do this. But in this case, the answer came from a place other than the inner corridors of Washington, D.C.
Civica Rx was established in Utah during 2018 to combat such shortages. It was first envisioned and developed by Dan Liljenquist, senior vice president and chief strategy officer at Intermountain Healthcare, who served as the incubator and provided infrastructure support until Civica Rx could be launched. It was founded by seven leading healthcare providers, including Intermountain Healthcare and three major philanthropies. Civica Rx benefits from its location in Lehi, amid Utah’s major universities and the “Silicon Slopes” start-up and tech community.
Civica Rx can produce lifesaving medicines less expensively and more predictably, because participating health systems know their needs and can commit in advance to bulk purchases at reduced rates. Those purchases enable manufacturers to re-enter the market or increase existing capacity at prices that are affordable and acceptable to the participating health systems.
Forty-five health systems are now members of Civica Rx, and they represent more than 1,100 hospitals in 46 states. In Utah, they include Intermountain Healthcare, MountainStar Healthcare, Steward Health Care, and University of Utah Health.
Riverton is just 14 miles north of Lehi, and the medication that Intermountain Riverton Hospital first received from Civica Rx is Vancomycin, an essential antibiotic that has often been in short supply at thousands of hospitals nationwide. Vancomycin is administered by an intravenous infusion and is used to treat serious infections caused by bacteria that are resistant to certain other antibiotics. The drug is now available to all participating health systems.
This first delivery is being followed up by 15 additional Civica Rx medications in production this year. These medicines are used daily by hospitals in emergency care, surgery, pain management, and in treating hypertension. Forty medications are expected to be available from Civica Rx by the end of 2020.
Civica Rx aims to stabilize the supply of antibiotics, anesthetics, cardiac medications, pain management medications and other essential medicines used in hospitals. It will do so by actively pursuing a three-pronged product supply strategy:
- It will work with multiple generic drug manufacturers who have FDA-approved manufacturing facilities and capacity to produce Civica Rx-labeled generic drugs.
- It will develop abbreviated new drug applications for generic drugs and work with contract manufacturing organizations to produce Civica Rx medications.
- It will acquire and build Civica Rx manufacturing facilities using its abbreviated new drug applications.
In these ways, Civica Rx will ensure that it has dedicated manufacturing capacity for the medications most desperately needed in U.S. hospitals, and its presence in Utah will grow in the process. Utah is where Civica Rx began, where it continues to lead this lifesaving effort, and where the state’s residents will continue to benefit in numerous ways from this essential initiative.
Marc Harrison, M.D,, is president and CEO of Intermountain Healthcare, based in Salt Lake City, which is a governing member of Civica Rx.