The shortage of intravenous fluids in the wake of Hurricane Helen has put a spotlight on the fragility and fragility of the country's medical supply chain.
The storm flooded the Baxter manufacturing plant in Marion, North Carolina, and left hospitals in chaos. The plant produces about 60 percent of the nation's intravenous fluids, including hydration fluids and dialysis fluids. The resulting shortage has forced hospitals to ration supplies.
Some are postponing elective surgeries, while others are restricting the use of IV bags except in emergencies. The shortage could last until at least the end of the year and comes as hospitals enter respiratory infection season.
“On the one hand, you know everybody's on deck and moving forward to where they need to be. But I just hope that [officials] Understand the scope of the problem,” said Chip Kahn, president and CEO of the American Hospital Federation.
According to a survey of more than 250 healthcare providers by supply chain company Premier, more than 86% of healthcare providers are experiencing IV fluid shortages due to Helen. The shortage was evenly spread across the country across all types of health care providers.
Nearly 17% of healthcare providers have begun canceling elective procedures, according to the survey, and more providers could follow suit next month if the situation doesn't improve. Approximately 54 percent of providers surveyed reported having less than a 10-day supply of IV fluids in stock.
“When you take that much supply out of the U.S. supply chain, it's going to cause havoc,” said Nancy Foster, vice president of quality and patient safety at the American Hospital Association. “That means everyone has their quota from their suppliers. …Everyone has been told to be very careful with their supply of these IV fluids and other fluids.”
Experts have long warned about the high concentration of critical supplies in one place, especially as climate change fosters stronger and more unpredictable storms.
However, sterility requirements in manufacturing mean high barriers to market entry, and with low returns on investment for manufacturers, hospitals and their suppliers have few options to fall back on.
It's common for the same product to come off and off the stock list for years. Prior to Helene, there had been a lack of specific IV solutions for almost a decade.
“Unlike, for example, a shortage of automotive chips, if there is a disruption in the medical supply chain, it is a major concern and a life-threatening problem.” said Tom Cotter, executive director of the advocacy nonprofit Healthcare Ready. “The risk of disruption impacting patient care is very high.”
Cotter and other experts said the only way for manufacturers to make a profit given the current environment is to consolidate their products and produce them at scale.
Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb said, “We currently consolidate the production of essential drugs in a small number of large manufacturing facilities, and when they fail, we lose a very large portion of the market.'' It will be stolen,” he said. On CNBC.
Baxter's North Cove plant ceased operations in late September when record rainfall from Helen flooded communities in western North Carolina, including Marion. In an update posted Monday, Baxter said 3,000 people are expected to be on the ground contributing to recovery efforts this week.
The company said its goal is to gradually restart production by the end of this year and return to 90 to 100 percent allocation for certain IV solutions around the same time. Moving product off-site for shipment to customers requires building a temporary bridge in the area, and the company said it is currently building a second bridge.
However, it is still unclear when production will fully return to pre-hurricane levels.
“Our main message to hospitals and health systems is save, save, save,” said Soumi Saha, Premier's senior vice president of government affairs.
Saha said he wants lawmakers and federal officials to have a serious conversation about strengthening the health care supply chain. Suppliers can take steps to prepare for potential shortages, such as keeping backup supplies on hand. But stockpiling isn't cheap, especially when there's a potential for shortages of certain products.
“We know something like this will happen again, but it's impossible to predict for which products it will happen, so it's a constant game of whack-a-mole,” Saha said.
Last week, the FDA approved temporary imports of IV fluids from Baxter facilities in Ireland, the United Kingdom, Canada and China to alleviate the shortage.
The FDA also released guidance that provides new flexibility to make it easier for hospitals and other facilities to create their own IV solutions during shortages.
Khan said greater flexibility will only help up to a point, as hospital pharmacies can barely make enough.
“There will not be enough production to meet the overall supply demand,” Khan said. “While useful and important for a comprehensive response to a problem, it is only part of a short-term solution.”
Hurricane Helen was not the first time hospitals and federal authorities have had to deal with shortages of critical medical supplies.
In a similar situation in 2017, Puerto Rico was hit hard by Hurricane Maria, and the Baxter factory, which made small IV bags, was shut down.
In 2023, a tornado damaged a Pfizer plant in North Carolina that produced about 25 percent of the company's generic sterile injectable drugs used in U.S. hospitals.
That same year, cancer centers across the country struggled to obtain key chemotherapy drugs. Inspection failures at Indian factories have led to significant downstream shortages and a frantic search for new suppliers.
“We hope that events like this continue to draw attention to supply chain vulnerabilities and patient vulnerability to drug shortages over the long term,” said Michael Ganio, senior director of pharmacy practice and quality at the American Pharmacopeial Association. said. Health system pharmacist.
Cotter said he believes some lessons have been learned from past crises, but he's not sure enough is being done to prevent the same problems from happening again.
“I don't know if it's political or what, but we're acting very short-sighted as a country. All the investments we need today should have been made 10 years ago. Resilience Because it takes time to build. [the] supply chain. It’s not going to happen overnight with a grant,” Cotter said.
