1.30.2014

Now It's A Normal Saline Shortage

If you ever wonder about the US health care system's ability to scale up for a mass epidemic or disaster all you have to do is look at its ability to handle season fluctuations in demand.

Short answer: Not very well.

Over the past two years we have found our self short, or out of many basic drugs needed to treat our patients. (For the current drug shortage list, Click Here)

None of these medications is as profitable as Viagra, so there is not a lot of incentive to invest in infrastructure for making them. The latest shortage is also the most basic. Normal saline, the IV fluid used as a front-line prevention and treatment for shock, has been in short supply.

Here's the lastest from the Emergency Nurses Association that showed up in my mailbox just now:
The Emergency Nurses Association (ENA) is closely tracking reports from hospitals across the country of a shortage of IV saline solution. According to the Food and Drug Administration (FDA) and the drug manufacturers, the increased demand from a harsh flu season and temporary shutdowns at some manufacturing plants are the cause of the shortage. 
The FDA is aware of the problem and is working with the three U.S. manufacturers of IV saline solution - Baxter, Braun Medical and Hospira - to increase the supply of this product. It is also looking at alternative sources, including importation from overseas.
The American Society of Health-System Pharmacists has stated that suppliers are now
operating at full production capacity in an attempt to meet the increased demand.  
In a January 17 letter to customers, Baxter said they “anticipate gradual improvement in the weeks ahead and are confident that these steps will enable us to achieve expected service levels.” Baxter also stated they are manufacturing a greater amount of IV solutions than in previous years and are taking steps to further increase capacity in 2014.
ENA is monitoring the situation closely and communicating information we receive regarding the shortage of IV saline solution to the FDA.  
In addition, ENA is working closely with other national healthcare organizations to ensure that the Food and Drug Administration Safety and Innovation Act (FDASIA), which was signed into law on July 9, 2012, is fully implemented so it provides the FDA with the tools to minimize future shortages of drugs or biological products. 
The key provisions of FDASIA dealing with shortages include:
• Broadening the scope of the early notification requirements by requiring manufacturers to notify the FDA of potential drug discontinuances; and
• Clarifying that the notification requirement applies to drugs that are used in emergency medical care or during surgery.

For more information on drug shortages and the FDA’s efforts to alleviate the shortage of IV saline solution, please visit: http://www.fda.gov/Drugs/drugsafety/DrugShortages/default.htm

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