After IV bag shortages in the first part of 2018, the supply line to hospitals is nearly fixed. Now, hospitals and state agencies are working together, creating a plan to avoid another shortage. The plan includes the North Dakota Department of Health, the Board of Pharmacy and local hospitals. Hurricane Maria exposed a major weakness in the national supply for IV bags. Until the federal government authorizes more manufacturing, agencies and hospitals say they'll need to get creative.
After Hurricane Maria ripped through Puerto Rico, U.S. hospitals spent months trying to stretch IV bag supplies. The largest manufacturer of IV bags for the state's was damaged in the storm.
"It was very critical and there were some weeks that were very difficult for health care facilities to muster through. The state's trying to talk about lessons learned by that,” said Mark Hardy, PharmD, ND Board of Pharmacy director.
Hospitals, along with the state board of pharmacy and department of health, are exploring how to maximize limited resources. Dr. Keith Horner, PharmD, with CHI St. Alexius in Bismarck thinks one option is rotating supply. "Bringing the supply they have on hand into the hospital and utilizing that here to create a rotation of stock so the product does not outdate at the North Dakota department of health,” said Horner
In January, St. A's said their deliveries were reduced by 40 percent. Another option is expanding the state's medical cache of supplies. The FDA's website shows not only IV bags are in limited supply.
"The other would be in the area of pain medicine like IV morphine. We've had ongoing challenges with supply of that product,” said Horner. Dr. Horner says the hospital always has around a month's supply. But having more at the state level could supply hospitals during a long term problem. "That way we can somewhat insulate the state of North Dakota from shortages. We're never going to prevent everyone, but hopefully we can help address some of the shortages that may occur in the future,” said Hardy.
But the hospitals and state agencies can only do so much, as most of the regulations are at the federal level. The manufacturing and distribution is regulated by the FDA. To help states out, more federal laws would need to change. We reached out to all of North Dakota's federal legislators to see if they're working on any possible solutions.
Sen John Hoeven, R-N.D., said in a statement: “We are aware of concerns related to medical device and product shortages caused by hurricanes that disrupted manufacturing in Puerto Rico. Our office has been in contact with the FDA, urging Commissioner Gottlieb to work with the industry and FEMA to make sure they prioritize addressing shortages. Among other things, the FDA has allowed imports of saline bags from international facilities, is helping U.S. facilities secure fuel and manufacturing supplies and is expediting reviews of alternative products to meet critical health care needs,”
Senator Heidi Heitkamp said: “This shortage uncovered vulnerabilities in the medical device supply chain that urgently need to be addressed. I have monitored FDA’s progress in dealing with the shortage, and will push for continued progress to diversify our sources of this life-saving equipment."
Congressman Kevin Cramer was unavailable for comment at the time this article was posted.