It’s 2023, and healthcare systems are still only required to document and communicate safety guidelines for hazardous drugs on the NIOSH 2016 list … In the meantime, the NIOSH 2020 list is available but is still not the required point of reference for hazardous drug (HD) lists. However, NIOSH 2016 may soon be out and NIOSH 2020 may soon be the law of the land under the name: NIOSH List of Hazardous Drugs in Healthcare Settings 2023. The updated list will be official once the Federal Register reviews and approves it, although we still don't have an estimated date. Until then, we are still referencing NIOSH 2016.
However, because healthcare systems must protect patients and healthcare workers from dangerous exposure to hazardous drugs, they cannot rely on NIOSH 2016 or even NIOSH 2020 alone. The FDA approves hundreds of new drugs every year - some of which may make it to your formulary or be brought in by patients - and drugs that may be considered hazardous must be assessed using the six characteristics of hazardous drugs.
According to Pharmacy Purchasing and Products’ annual survey, only 22% of the more than 225 pharmacy directors they surveyed have added hazardous drugs to their list beyond the NIOSH list.
This stat isn’t in line with what we see from our clients, many of whom have added hazardous drugs to their lists. We’ve seen as few as 50 drugs for those facilities that do not do any compounding and/or infusions. We’ve also seen more than 350 drugs if a facility includes every hazardous product that could come through the door, whether it be investigational drugs or hazardous medication brought in by patients on continuing therapy. For reference, the current NIOSH list is composed of approximately 225 hazardous drugs - two antineoplastic agents were just added to Group 1: Lurbinectedin (Zepzelca) and Mirvetuximab Soravtansine (Elahere).
Staying on top of both newly listed drugs on the NIOSH list and assessing whether new FDA-approved drugs should be considered hazardous is a tedious, time-consuming task. However, the safety of both patients and healthcare workers depends on it.
To help you with this monumental task, Rpharmy is sharing newly FDA-approved drugs that our clients have assessed and added to their HD list. These drugs get posted to Twitter as a client adds them to the list, and once a month, we will also begin sharing on LinkedIn. We hope this expedites the process of assessing whether your system or facility should consider a new drug hazardous.