A scarcity of IV fluid within the wake of Hurricane Helene is shining a highlight on the fragility and vulnerability of the nation’s medical provide chain.
Hospitals had been left scrambling after the storm flooded a Baxter manufacturing plant in Marion, N.C. The plant makes about 60 p.c of the IV fluid within the nation, together with hydration and dialysis options. The ensuing scarcity has compelled hospitals to ration provides.
Some are suspending elective surgical procedures, and a few are proscribing using IV baggage until it’s an emergency. The scarcity may final till not less than the top of the yr, posing an issue as hospitals enter into respiratory an infection season.
“On the one hand, you know all hands are on deck and moving forward where it needs to be. But I just hope that [officials] understand the scope of the issue,” mentioned Chip Kahn, president and CEO of the Federation of American Hospitals.
Greater than 86 p.c of well being care suppliers are experiencing shortages of IV fluids within the aftermath of Helene, in keeping with a survey of greater than 250 well being suppliers from provide chain firm Premier Inc. Shortages had been evenly unfold nationwide, throughout all supplier sorts.
The survey discovered practically 17 p.c of suppliers had been beginning to cancel elective procedures, and extra might comply with go well with within the subsequent month if the scenario doesn’t enhance. About 54 p.c of suppliers within the survey reported they’d 10 days or fewer of IV fluids in stock.
“When you take that much supply out of the supply chain in the U.S., it creates havoc,” mentioned Nancy Foster, vp for high quality and affected person security on the American Hospital Affiliation. “So everyone is on allocation from their supplier. … Everyone is being told to be very careful with their supply of these IV solutions and other fluids.”
Specialists have lengthy warned about permitting crucial provides to be extremely concentrated in a single place, particularly as local weather change fuels extra highly effective and unpredictable storms.
However manufacturing necessities for sterility means a excessive barrier to entry into the market, and with low returns on funding for producers, hospitals and their suppliers have few choices for recourse.
It’s frequent to see the identical merchandise go on and off the scarcity listing for years. Previous to Helene, sure IV options had been in scarcity for nearly 10 years.
“Not like shortages for automotive chips, for instance, it’s a main concern and a life-threatening challenge when there is a medical provide chain disruption,” mentioned Tom Cotter, government director of Healthcare Prepared, a nonprofit that helps bolster provide chains throughout and after disasters. “The risks are so much higher for disruptions affecting patient care.”
Cotter and different consultants mentioned the one method for producers to make a revenue given the present atmosphere is to consolidate and produce their merchandise at a big scale.
“So now you have consolidated manufacturing for essential medicines in a small number of large manufacturing facilities, and when those go down, you take out a very large percentage of the market,” former Meals and Drug Administration (FDA) Commissioner Scott Gottlieb mentioned Tuesday on CNBC.
Baxter’s North Cove plant shut down in late September, when file quantities of rainfall from Helene inundated western North Carolina communities, together with Marion. In an replace posted Monday, Baxter mentioned they anticipate to have 3,000 individuals on website contributing to restoration efforts this week.
The corporate mentioned its objective is to restart manufacturing in phases by the top of this yr, and to return to allocating 90 to one hundred pc of sure IV options in the identical interval. A brief bridge wanted to be constructed within the space to assist transfer merchandise off website to ship to clients, and the corporate mentioned a second is at the moment being constructed.
However they don’t but have a timeline for when manufacturing shall be totally restored to pre-hurricane ranges.
“Our primary message to hospitals and health systems is conserve, conserve, conserve,” mentioned Soumi Saha, Premier’s senior vp of presidency affairs.
Saha mentioned she hopes lawmakers and federal officers have severe conversations about strengthening well being care provide chains. Suppliers can attempt to take steps to arrange for potential shortages, together with protecting additional provides available. However stockpiling isn’t low cost, particularly when any given product may go into scarcity.
“We know it will happen again, but it’s impossible to predict to what product. And so it is a constant game of whack-a-mole,” Saha mentioned.
Final week, FDA authorised momentary imports of IV fluid from Baxter services in Eire, the UK, Canada and China to ease the scarcity.
FDA additionally launched steering offering new flexibility that makes it simpler for hospitals and different services to make their very own IV options through the scarcity.
Kahn mentioned that added flexibility is useful solely up to some extent, as a result of hospital pharmacies can’t make practically sufficient.
“It’s not going to be sufficient production there to answer the supply need overall,” Kahn mentioned. “It’s useful and important in a comprehensive response to the problem, but it’s only a small part of whatever a short-term solution is.”
The aftermath of Hurricane Helene was removed from the primary time hospitals and federal officers have wanted to navigate shortages of crucial medication.
In an analogous scenario in 2017, a Baxter plant in Puerto Rico that manufactured small IV baggage shut down after the island suffered a direct hit from Hurricane Maria.
In 2023, a twister broken a Pfizer plant in North Carolina that made practically 25 p.c of the corporate’s generic sterile injectable medicines utilized in U.S. hospitals.
That very same yr, most cancers facilities throughout the nation struggled to acquire key chemotherapy medication. A failed inspection at a plant in India led to huge downstream shortages and determined searches for brand new suppliers.
“I’m hopeful that over time, events like this continue to keep attention on the fragility of the supply chain and the vulnerability of our patients to drug shortages,” mentioned Michael Ganio, senior director of pharmacy apply and high quality with the American Society of Well being-System Pharmacists.
Cotter mentioned he thinks there have been some classes discovered from previous crises, however he isn’t positive there’s sufficient being finished to cease the identical points from taking place once more.
“I don’t know if it’s political will or what, but we’re acting very shortsighted as a country. All of the investments that we need today needed to be made 10 years ago, because it takes time to build a resiliency into [the] supply chain. It doesn’t happen overnight with a grant,” Cotter mentioned.
