Wayne Russell, senior director of pharmacy at Premier, Inc., a group purchasing organization, has a similar take. "My view is not the same as the FDA's. The FDA has said the shortage was caused by an increased number of flu cases and extra hospitalizations… and use of fluids, but I can tell you that every manufacturer of IV fluids in the US has had recent [manufacturing related] quality issues."
Russell says those quality issues necessitated a manufacturing slowdown and "they still haven't caught up with demand."
A High Price to Pay
Whatever the cause of the shortage, its effect is hitting hospital budgets. Jaspan's longtime supplier, proposed a price hike of "300%—that would have been my increase had I stayed with Hospira," says Jaspan. He found an alternate vendor.
When substitution or careful rationing of saline isn't enough, organizations can expect to feel the pinch when paying for saline. "The product being imported to the US is about ten times higher than [what hospitals are accustomed to paying], said Russell.
So far, the FDA has given a major European manufacturer of saline, Fresenius Kabi, permission to export saline manufactured in Norway to the US, and is allowing Baxter to supplement its normal supplies with saline manufactured in its plant in Spain.
It must be distributed through the normal channels and "it's being very tightly managed," says Russell.
The manufacturers have handled allocation and distribution of saline throughout the shortage. "They try to fairly distribute it. If they didn't do that, you would have some hospitals buying more than they need and hoarding it," he said.