1. IV BRIEFING: Emergency Preparedness Coordinating Council
January 18, 2018

2. IV fluids Issues Product lines impacted
Product shortages and allocations are expected to continue for the next several months
At a minimum, the next several weeks are critical, as manufacturing plants come back online
Inventories are expected to begin to recover but are fragile
Product availability changes from week to week and must be closely managed
IV fluids (sodium chloride, dextrose, lactated ringers)
Nutritional products (amino acids)
Medication delivery (mini-bags, compounding bags)
Large-volume irrigation fluids in bags
Evacuated containers

3. IV Market Dynamics IV inventory levels remain very tight related to
market consolidation
Baxter plant maintenance shutdown deferred to Spring
quality controls and FDA requirements
production lines being shifted to meet critical demand
recent natural disasters
creates other temporary shortages (Braun and Baxter)
Puerto Rico (Hurricane Maria) – Baxter – mini-bags and amino acids
product allocations by manufacturers to committed customers in order to protect/manage inventory
Mexico (earthquake) - Baxter sets
California (wild fires) – Braun – all products - logistics
planned plant maintenance resulted in a recent two-week shutdown (Braun)
flu is now widespread (U.S. and NYS)

4. NYS Flu Report
Source: health.ny.gov

5. NYS Flu Report
Source: health.ny.gov

6. U.S. Flu Report
Source: cdc.gov

7. Key Activities
Regular updates and communications to C-suite/Supply Chain/Rx
Advocacy efforts – FDA Office of Drug Shortages and Congress
Regular meeting with FDA
IV education and knowledge-sharing forum
Letters to the FDA
Create awareness of current shortages and impact
Market overview
Support for importation of product that meets U.S. standards (Baxter=Ireland, Australia)
Conservation and Supply Chain strategies
Accelerated review/approval
Best practice networking forum
Weekly status updates to monitor situation and provide member feedback

8. What can you do? Hospitals are strongly advised to
develop proactive communication and education to leadership, nursing, medical staff, etc.
hold regular meetings to review IV needs/delivery projections to develop/implement contingency plans. Meetings should include the following:
create conservation strategies where clinically appropriate
Hospital (Supply Chain, Rx, Nursing, etc.)
develop alternative clinical therapies/approaches and substitute products
Manufacturers
Distributors
Order full allocations
implement centralized inventory control methods for critical products

9. Questions
Jay Fligstein Sr. Vice President Acurity, Inc. O: (212) | C: (646)