Reliance Wholesale, Inc., is a pharmaceutical company that provides the Contra Costa Regional Medical Center and Health Centers with medications and pharmaceutical products unavailable through the contracted wholesaler and the direct manufacturer of these products. The U.S. has been experiencing a rapidly increasing frequency of drug shortages in the past two decades, which have caused numerous difficulties for clinicians, health care facilities, patients, and federal regulators. Drug shortages remain to be the most burdensome obstacle in providing optimal level of care in the healthcare industry from the medication management perspective. This problem has been intensified in the past nine months due to the pandemic, creating a new level of challenge in healthcare. This is important as the shortage affected the most vulnerable patient population affected by COVID in the most critical environments of the hospital being ICU and emergency care settings with a specific “type” of critical medication not being immediately available nationwide.  
  
Drug shortages are caused by many factors, including difficulties in acquiring raw materials, manufacturing problems, regulatory issues, and business decisions, as well as many other disturbances within the supply chain. They adversely affect patient care by causing substitution of safe and effective therapies with alternative treatments; compromising or delaying medical procedures; or causing medication errors. Drug shortages also have significantly burdened health care providers and health care facility finances and personnel. At CCRMC, when clinically proven, Pharmacy substitutes the shorted item with compatible alternatives. However, when this is not doable or clinically indicated and in order to optimize the standard of care, we must obtain the product via reputable resources such as Reliance.

If this amendment is not approved, we will not be able to take care of our patient population at the Contra Costa Regional Medical Center and Health Centers.