As a result, pharmacists are scrambling daily to find more and to figure out alternative dosing regimens. The constant changes put extra stress on hospital pharmacists, increase the risk of mistakes, and lead to waste and higher costs. Nishaminy Kasbekar, director of pharmacy at Penn Presbyterian Medical Center, said her hospital has had to turn to more expensive alternatives at an extra cost of $30,000 over the last three months. Three months ago, she said, the hospital could get 20 percent to 30 percent less of those three drugs than it wanted. Now, it's 50 percent to 60 percent less.