Breaking news: IV contrast shortage hits US healthcare system

The US healthcare system is facing an IV contrast shortage, MDLinx has learned, and that shortage may have sweeping implications for physicians’ daily practice.

A spokesperson from the American Hospital Association (AHA) confirmed the shortage on May 5, saying hospitals have reported low supplies for about a week.

With low stockpiles of IV contrast, AHA anticipates this will affect any CT imaging requiring media. Under normal circumstances, it’s estimated that more than 75 million CT scans are performed annually in the US.

“Hospitals are exploring various conservation strategies, including the use of other imaging technologies, using other contrast agents, rationing contrast—to give a few examples—to try to continue to provide care,” Milligan said.

Milligan added that AHA has raised the issue with the Biden administration.

Origin of the shortage

Inklings of widespread supply issues began to circulate on the r/medicine sub-Reddit on April 22. Sub-Reddit users identifying as HCPs described shortages in California, Texas, and Maryland. Users reported switching to non-contrast scans where possible, rationing contrast, and postponing non-critical exams.

It’s possible these measures will need to continue. The Greater New York Hospital Association (GNYHA) has since issued a news release explaining how the shortage happened, and it’s a familiar, post-COVID supply chain narrative.^[]

All GE Healthcare iodinated contrast media, including all versions of Omnipaque (iohexol), is made in a single Shanghai facility. Since March 31, Shanghai has been under COVID lockdown, which shuttered the facility for an unspecified length of time.

According to GNYHA, while the facility has reopened, lost production time has created an 80% supply reduction that will persist for 6 to 8 weeks, indicating that a beleaguered healthcare system will once again have to adjust.

Ongoing issue

Ongoing shortages stemming from supply-chain disruptions include heparin, 50% dextrose injection, diphenhydramine injection, and various local anesthetics.

As with other industries, the manufacturing and shipping of drugs, medical devices, and basic supplies such as PPE has been hampered by a confluence of a number of factors.

US ports have seen record levels of congestion, making it difficult to distribute goods. Freight and transportation costs have risen with the price of fuel. Raw materials have become more difficult to source. Natural disasters—and most recently, the war in Ukraine—have disrupted markets. Labor shortages have made goods harder to manufacture and ship. And China, a major producer of medical products, is facing an energy crisis.

Making healthcare supply chains more resilient remains largely a work in progress and falls outside the scope of clinical practice. A 2022 Journal of Purchasing and Supply Management study urges hospitals to obtain supplies directly from manufacturers instead of distributors, and to exchange resources with other hospitals.^[]

What clinicians can do, said one Reddit user claiming to be an EM, is communicate:

“As clinicians we can help identify alternative procurement sources, and be creative about workarounds. Share info as you are doing.”