Why IV shortages were a long-standing issue even before Helene: 6 things to know

Hurricane Helene has put IV shortages in the spotlight after damaging a manufacturing plant, but hospitals have been dealing with IV fluid shortages for years, NBC News reported Oct. 18.

Here are six things to know:

1. According to the FDA, three IV fluids have been in chronic shortage for years. Saline solution has been in shortage since 2018, sterile water has been in shortage since 2021 and dextrose solution has been in shortage since early 2022.

2. Hurricane Helene damaged a Baxter International plant in North Carolina, triggering additional shorages of dextrose solution, an electrolyte solution called lactated Ringer's and a peritoneal dialysis solution. Currently, hospitals are getting about 40% of their normal shipments.

"[T]his particular shortage on these particular IV fluids is not something we've encountered," Chris DeRienzo, MD, a neonatologist and the chief physician executive of the American Hospital Association, told NBC.

3. The underlying reason for the long-term tight supply of IV solutions is their overall low profitability. These solutions have a high barriers to market entry, with large time and cost commitments to meet regulatory requirements, as well as high demands for space and weight. There are pressures to keep prices low, as well.

4. The U.S. IV fluid market is sustained by four manufacturers: Baxter International, which makes about 60% of IV liquids, B. Braun Medical, which makes about 23%, followed by ICU Medical and Fresenius Kabi.

5. To alleviate current shortages, President Biden invoked the Defense Production Act, a wartime power that will prioritize resources to Baxter to clean and rebuild its facility. The FDA is also temporarily allowing Baxter to import products from its plants in Canada, China, Ireland and the U.K.

6. Experts told NBC that the long-term shortages will persist unless there is a guarantee of long-term profits for companies from IV solutions.

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