CHA News Article

National IV Fluid Shortage Continues
Adequate supplies expected by late spring

On Feb. 11, CHA updated hospitals with recommendations for managing current IV fluid supply shortages. This week, more information has emerged about reasons for the shortage and the products most affected.

The primary U.S. manufacturers — Hospira, Braun and Baxter — cite increased national demand and flat supply as the reason for the normal saline shortage. In a letter to its customers, Hospira cited increased demand from this year’s flu season and industry supply constraints. All three manufacturers have placed limits on the quantities of the solutions hospitals they contract with can receive, based on historical demand, for fair distribution. Manufacturers expect to be able to increase production to adequate supplies by May or June.

The 1000 mL bags of normal saline are in shortest supply at this time, although the shortage is also impacting other IV fluids due to shifting demand. The Food and Drug Administration (FDA) offers a shortage list and other resources at The American Society of Health-System Pharmacists (ASHP) reports current shortages of 0.9% NaCl, 0.45% NaCl, 5% dextrose injection, and lactated ringers solutions in large volume sizes (250-1000 mL).

In early February, ASHP conducted a survey of directors of pharmacy to gauge the scope of the problem. A preliminary report of the results is available on the ASHP website.

Some state officials have inquired about tapping into their emergency management caches or requesting release from the Federal Strategic National Stockpile. However, federal officials have stated that there is no immediate plan to use stockpile supplies because the quantities of saline are insufficient to meet current needs for more than a few days, and depleting them reduces the country’s ability to respond to a national emergency.

The FDA is working with the three manufacturers to help preserve the supply of these necessary products. The agency has restated its commitment to doing everything it can to address drug shortages, including finding alternative sources (including possibly importing supplies from overseas), so that patients can get the medicines they need. The FDA also has indicated that it will notify the American Hospital Association as soon as new information about additional supplies is available.

CHA’s Medication Safety Committee continues to monitor drug shortages and will continue to update members with new information and resources.