June 05, 2017
A nationwide shortage of sodium bicarbonate solution is causing hospitals to postpone procedures and pharmacists to strategize how to best use their dwindling supplies, the New York Times recently reported.
“As I talk to colleagues around the country, this is really a problem we’re all struggling with right now,” Mark Sullivan, head of pharmacy operations at Vanderbilt University Hospital and Clinics, told the newspaper (May 21, 2017).
The report traces the beginning of the sodium bicarbonate solution shortage to February, when Pfizer—1 of only 2 US suppliers—experienced a problem with an outside supplier. After Pfizer announced its shortage, the other maker, Amphastar, experienced a boost in demand, causing it to experience shortages, too. Pfizer later announced a worsening situation with its supplier.
Product makers are unsure when sodium bicarbonate solution will become plentiful again, according to the New York Times, which reported “August or later” for some forms of the drug. In the meantime, pharmacists are doing what they can to stockpile the drug, which is used in a wide range of procedures including open-heart surgery, certain kinds of chemotherapy, and even as a poison antidote.
At Providence Hospital, head pharmacist Gino Agnelly told the newspaper he recently scavenged vials from crash carts throughout the building. He also searched online to see if he could mix baking soda and water to make his own. (He dropped the idea after finding just 1 research paper from 1947 that mentioned it.) Bigger hospitals with compounding pharmacies are beginning the process of making their own sterile sodium bicarbonate solutions, however.
According to US Food and Drug Administration spokeswoman Andrea Fischer, the agency is working with Pfizer and Amphastar and, she told the New York Times, “exploring all possible solutions to this critical shortage, including temporary importation, to help with this shortage until it’s resolved.”
For now, hospitals and pharmacists are grappling with some difficult decisions regarding patient care. Providence Hospital reportedly postponed 7 open-heart surgeries in 1 week.
“Does the immediate need of a patient outweigh the expected need of a patient?” Agnelly mused in the article. “It’s a medical and ethical question that goes beyond anything I’ve had to experience before.”