Jun 29, 2023 - Health

Health systems plagued by spot shortages scramble for essentials

Illustration: Aïda Amer/Axios

Health systems that had to ration supplies during the pandemic are now facing disruptions of basic needs like syringes, surgical tourniquets, chest tubes and compounds for CT scans — and spending huge sums on workarounds.

The big picture: Drug shortages aren't the only supply problem plaguing U.S. health care as providers navigate an increasingly volatile environment characterized by acute spot shortages and manufacturing and logistics issues. The crunch isn't expected to ease for at least a year.

  • The problems are "shorter duration but much more dynamic and unpredictable" than during the pandemic, said Kyle MacKinnon, a senior director of operational excellence at Premier. "It's described as like whack-a-mole, going from one product to the next."
  • Hospitals last year spent $1.1 billion just buying substitute pharmacy products when the originals were unavailable due to shortage, Premier data shows.

Between the lines: The health care supply chain is moving out of crisis mode, when lockdowns and congestion at U.S. ports delayed shipments and led to pervasive shortages.

  • Now, problems are popping up in niches often dominated by a small number of manufacturers, compounded by a scarcity of highly skilled labor in pharmaceuticals and medical devices.
  • Integra LifeSciences recently recalled surgical mesh and tissue mending products made in a Boston facility, forcing clinicians to scramble for alternatives, MacKinnon said.
  • The Food and Drug Administration this month recommended health care facilities ration tourniquet cuffs used in emergency and trauma settings and elective limb surgeries, per Becker's Hospital Review.
  • Supply chain pressures in China contributed to a shortage of contrast media that kept 10% of hospital inpatients from getting a CT scan or other advanced imaging as part of their care.
  • There also have been shortages of essentials like body fluid warming systems, balloon catheters, fetal monitoring devices to measure heart rates and chest drainage and suction canisters.

By the numbers: Big health systems are seeing shortages of upwards of 600 products and 200-300 drugs a month, per Premier.

  • Providers are 2.5 times likelier to experience shortages on products in markets that have two or fewer manufacturers accounting for more than 80% of market share.
  • Nearly half of respondents (48.6%) to a Premier survey of health and supply chain officials said they had to cancel or reschedule cases or procedures at least quarterly in 2022 due to product shortages.

Flashback: The CARES Act included provisions to address anticipated drug and device shortages, including requirements that manufacturers report looming problems to the FDA.

  • It also required companies to maintain redundancy and contingency plans to ensure ongoing supply.

What we're watching: Players up and down the supply chain are reevaluating their supply strategies and examining whether too much business is being outsourced to manufacturers and suppliers overseas.

  • Congress also is weighing a reauthorization of pandemic preparedness legislation and steps that could strengthen the Strategic National Stockpile.
  • Providers who find short-term alternative sources of equipment can expect to pay more just to get products in the door.
  • "There could be major cost pressure for health systems having to pay a certain percentage higher just to secure the product," MacKinnon said.
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