IV Solution Shortage SPOTREP 2

October 3, 2024  /  TLP: CLEAR

Healthcare Ready is ENGAGED for this event. We are monitoring potential concerns for supply chain disruptions and impacts on healthcare services on our Alert Hub.

Contents

• Situation Overview
• Potential Supply Chain Impacts
• Impacted Products
• IV Solutions Conservation Methods

Situation Overview

• Baxter’s North Cove plant located in Marion, North Carolina experienced flooding from Hurricane Helene and is currently closed for production. The facility specializes in the production of intravenous (IV) and peritoneal dialysis solutions and is the leading US manufacturer of these products.
  • Baxter is continuing to assess damages and take immediate action in the effort to resume product as quickly as possible. They are also working with their additional facilities to increase supply and reduce the risk of new shortages.
  • Baxter is also actively working with the FDA, HHS, and other government partners to assess potential supply chain impacts of intravenous and peritoneal dialysis solutions in the US.
• The FDA, HHS, and other government agencies are working to mitigate supply chain disruptions of these critical products – including determining how much product may be available at wholesalers and providing as many resources as possible at this time.
  • As of October 1, the FDA has not declared any shortages related to the products produces at the North Cove plant.

Potential Supply Chain Impacts

• The East Coast and Gulf Coast Port Strike may escalate the urgency and logistics of supply movements. Additionally, because of the weight and bulkiness of IV solutions, there is a limit on the volume that can be transported by air.
• After similar disasters, officials implemented measures such as fast-tracking the review process for drug applications aimed at alleviating shortages and encouraged companies with FDA-approved saline products to increase their production capacity.
  • In addition to these efforts, hospitals and other healthcare facilities typically work to conserve as much of the affected product as possible and explore potential alternatives or substitutes.
  • Similar measures may be required in the near future, given that there is currently no projected timeline for when the facility will become operational again.
• There has been an ongoing shortage of IV fluid products, which is especially notable in Australia whose suppliers include Baxter, B. Braun, and Fresenius Kabi.
  • Shortages are due to multiple factors including global supply limitations, unexpected increases in demand, and manufacturing issues.

Impacted Products

• The table below shows the impacted products, manufactured at the Baxter North Cove plant.

IV Solutions Conservation Methods

• Here are a few things healthcare practitioners can do to manage and conserve IV solutions and products:
  • Evaluate current stock levels, expiration dates, and the distribution of IV solutions.
  • Collaborate with clinical teams to identify which patients are in critical need of impacted IV solutions.
  • Identify alternative sources of solutions and medications such as oral rehydration for non-critically ill patients.
  • Optimize fluid management to minimize waste.
  • Assess pharmacy operational strategies.
  • Engage clinical teams on managing fluid restrictions, medication changes, and potential risks.
  • Document and monitor fluid usage, patient needs, and any shortages encountered.
• The American Society of Health-System Pharmacists (ASHP) has published suggestions for management and conservation of IV solutions, which can be found here.

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