Hospitals, pharmacies monitoring drug shortages

Feb. 18--MANKATO -- Hurricane Maria's impact continues to be felt far beyond Puerto Rico, including at hospitals and pharmacies in southern Minnesota.

The natural disaster tore through medical manufacturing plants on the island in September 2017, causing a shortage of the IV bags used to deliver patients' medicine at hospitals across the mainland United States.

Hospitals in southern Minnesota report they've managed the shortage so far, even as they contend with the worst flu season in recent memory.

"We have in the past run out of some of the sizes we use, but we've been able to substitute with other sizes," said Stephanie Holden, chief marketing and development officer at River's Edge Hospital and Clinic in St. Peter.

Swapping in another size doesn't impact care, while the hospital has never run out of bags. Holden said the backlog requires diligent restocking before supply gets low.

"It's still an issue," she said. "We're just making sure we have enough inventory and placing orders every week because there's a backup."

Spokespersons from Mayo Clinic Health System in Mankato and Allina Health's New Ulm Medical Center said they've been monitoring possible shortages as well.

"With a few exceptions, product availability for the most part has not been interrupted," Mayo in Mankato said in a statement. "The most notable impact has been in IV solutions manufactured by Baxter."

Baxter, a leading IV bag maker, was hit hard by the hurricane. The Mayo statement went on to say Baxter has been willing to work with impacted organizations.

"We are optimistic that we will be able to work through any associated issues as a result of this hurricane," the statement said.

Not all hospitals have felt the strain caused by a tightened IV bag market. Dona Rehome, Madelia Community Hospital and Clinic's marketing coordinator, said the health center was aware of the shortage but hadn't been impacted.

Hospitals in larger metros could be feeling the brunt of the strain. Some across the country sought alternatives to the IVs like nasal sprays to ration their bags. They also employed a procedure called "IV push," where nurses inject medication into the patients' IV line.

In a letter last month, the Minnesota Hospital Association asked Baxter to look into redistributing more bags to the region from its other sites.

"This shortage places Minnesota hospitals and health systems in jeopardy of not being able to provide basic patient care," the letter read.

Puerto Rico is also a significant manufacturer base for many drugs prescribed in the U.S. Last fall the U.S. Food and Drug Administration reported it was monitoring shortages of as many as 40 drugs following the hurricane.

The list has shortened since then, but common drugs remain in shorter supply. Mark Frost, a longtime Mankato pharmacist, said the hypothyroidism-treating levothyroxine is just coming back in stock.

"It's coming back on line now," he said. "It's been basically in short supply or no supply for quite a while."

The short supply brought the price up for customers. When it wasn't available at all, pharmacists, doctors and customers found alternatives.

"For the most part the market took care of things, but it was a pain to put it mildly," Frost said. "It was a fairly dramatic impact in the U.S."

A drug for high blood pressure, atenolol, had a shortage even before the natural disaster. It can come in 25, 50 and 100 mg tablets, so if one wasn't available, the tablets had to be split.

Unlike any sticker shock experienced by patients buying their medication, the hurricane's impact at hospitals is more behind the scenes.

Holden said patients at River's Edge may not have even noticed there was a shortage.

Follow Brian Arola @BrianArolaMFP.

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