Baking soda shortage has hospitals frantic, delaying treatments and surgeries

[Jimbo101]

ARS Technica

Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate—aka, baking soda.

The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February.

The country’s two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer’s suppliers—the issue was undisclosed due to confidentiality agreements. Amphastar’s supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don’t know when exactly supplies will be restored. They speculate that it will be no earlier than June or August.

As hospitals and pharmacists struggle with the sodium bicarbonate shortage, experts note that it’s just the latest example of stocks of inexpensive, essential generic medicines hitting alarming lows. For example, there was a sodium bicarbonate scarcity in 2012 and a similarly alarming shortage of saline solution in 2014.

Experts blame the shortages on a combination of factors, including problems getting raw materials, issues with aging facilities where many old drugs are manufactured, and consolidation in the industry that reduces the number of potential suppliers. There’s also the concern that because generic drugs are unlikely to drive profits, drug companies may not make necessary investments to maintain supplies.

[Vinca]

1. I'm sure big pharma can come up with an alternate product . . . for the right price.

[sinkingfeeling]

2. Maybe we could import some from Canada or Mexico?

[Warpy]

3. Consolidation is the problem. With few places manufacturing sterile

Last edited Mon May 22, 2017, 06:36 PM - Edit history (1)

sodium bicarbonate in various solutions, everybody all over the planet experiences the same shortage at the same time.

Expect to see a lot more of this happening as drug companies are snapped up by big conglomerates and closed down to reduce competition.

Centralized, monopolistic production looks great to shareholders but it doesn't serve health care at all.

[Barack_America]

4. Oh man, that's bad, word to the wise, don't go septic for a while...

[dembotoz]

7. that is not on my bucket list...wonder if it was better when we just didn't know

[Warpy]

9. Don't do it while diabetic, at any rate

[Nictuku]

5. The result of Health Care for Profit

[frazzled]

6. How about this?

$7.99 for 13.5 lbs. Though I doubt it's medicinally pure.

[Warpy]

10. The problem is that it needs to be in a very precise concentration

and completely sterile and just shoving it into the GI tract is not efficient enough to save a life during cardiac arrest.

[jmowreader]

8. This seems like the perfect kind of product for a hospital's pharmacy to make

Sigma Aldrich sells pharm-grade bicarbonate, and the other two ingredients are sterile water (which you make in your own autoclave) and little injectable-drug bottles from Hospira.

[Warpy]

12. The bicarb has to be sterile, also, and that means the same plants would manufacture it

and since those plants are consolidated, when one has a manufacturing problem (as now), there will be a massive shortage.

You can't just mix Arm & Hammer with sterile water and expect to shoot it into a vein. The patient might survive the acidosis only to die of sepsis.

[Crunchy Frog]

11. Either break up the pharma companies, or nationalize them. n/t

[FiveGoodMen]

15. Hear, hear!

[WinkyDink]

13. N/m.

[WinkyDink]

14. Let's boil it down, shall we? $$$$$$$$$$$$$.

[hunter]

16. This reminds me of the recent nitrous oxide shortage.

It turns out a large fraction of the U.S. nitrous oxide supply was being manufactured in one place, from byproducts of nylon production.

When that plant was destroyed in an explosion there were severe shortages.

https://www.theatlantic.com/science/archive/2016/12/the-deadly-explosion-behind-americas-whipped-cream-shortage/511118/

Maybe there's a lesson here about putting all your eggs in one basket...

I'd love to know what the undisclosed reasons are for this shortage. I'm hoping it wasn't a switch to Chinese suppliers, similar to the great wallboard catastrophe, or due to some corner-cutting by U.S. producers.

The worst thing would be if this is a deliberate effort to raise prices by Pfizer, in effect holding very ill people hostage. Pfizer isn't being transparent here, and whatever "confidentiality agreements" they've entered into are bad medicine. I wish we had an FDA we could trust to represent the public's best interests.

[hatrack]

17. See also: "Efficiency"; "Consolidation"; "Rationalization"; "Shareholder Value"