The government is stepping in to coordinate the distribution of IV fluids across the country in response to a shortage of the vital medical supplies.
The shortage, which is expected to continue throughout 2024, has shone a light on the vulnerability of Australia’s supply chain and ability to source crucial health supplies beyond medicines.
Australia receives IV fluids from three suppliers: B Braun and Fresenius Kabi manufacture supplies overseas, while US multinational Baxter Healthcare has a plant in western Sydney.
Baxter Healthcare said its facility was “operating at full capacity”. It was also still fulfilling its contractual requirements to supply partners in New Zealand, whose drug-purchasing agency said it had no current issues with supply.
To date, there has been no central authority that controls supplies of IV fluids in Australia. The product is procured by state and territory governments for their hospitals, and independently by private hospitals and GP groups.
Despite being essential and ubiquitous in healthcare, IV fluids are not a reportable medicine under commonwealth therapeutic goods legislation, a system which flags shortages very early.
That is about to change.
After a meeting on Friday of federal, state and territory health ministers, it was announced immediate steps would be taken to ensure a coordinated approach to distribution across the jurisdictional supply chains.
There would also be greater data sharing between jurisdictions on usage and supply, with producers and suppliers of IV fluids made to provide data on supply and production forecasts. This would help officials better understand the severity and duration of the shortage.
The ministers’ statement after the meeting said that “shortages of IV fluids, while easing, are expected to continue through 2024”.
They sought “to provide reassurance to all Australians that supply challenges are being addressed and that health services are continuing”.
The shortage has been blamed on global manufacturing issues and an unexpected increase in demand.
Prof Steve Robson, the president of the Australian Medical Association, said there was “no scandal whatsoever” with global supply limitations on a range of medical products.
“I spoke to my colleagues in the US and UK [and] they have different supply shortages, there’s no doubt about that. They are facing shortages of other products such as irrigation fluid and plasma lite.”
However, Robson acknowledged other countries did not have the same supply constraints in the delivery of products as Australia, because of its far-flung location.
Part of the problem that Robson said needed addressing in future was that “no one knows how much [IV fluid] we make here versus what we get overseas”.
As for Baxter Healthcare shipping IV fluids to New Zealand while Australia suffered a shortage, Robson said contracts had to be fulfilled.
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“The big lesson is that everyone has inherited a system [with] no central monitoring,” Robson said. Australia needed a transparent inventory of critical medical supplies beyond medicines such as antibiotics, he said.
Robson said the government’s response, bringing together all states and territories and the commonwealth along with other healthcare stakeholders, was “fantastic”.
The response group would meet on a weekly basis, or more frequently if required, while supply remained constrained. It had also been directed by ministers to consider options to maintain supply of IV fluids within Australia.
After speaking with the chair of the taskforce, Robson said there was “no threat to patient care” right now. “Patients should go into the next couple weeks feeling confident.”
He said he was unaware of any care being compromised anywhere in the country.
Robson said in his own practice as a surgeon they were unable to use the IV fluids they usually use, but different safe fluids were available.
“It’s like you’re planning a dinner party and say you are serving chicken kiev. But on the day, no chicken is available so you have to change to veal parmigiana.”
The Therapeutic Goods Administration said the current supply of IV fluids was being affected by global supply limitations, unexpected increases in demand and manufacturing issues.
It said it was aware that supply of some IV fluids was also constrained in other countries, such as the US and Canada, according to their shortage report databases.
Fresenius Kabi said some of its IV fluid lines had been “impacted by significant increases in local demand, global shortages and delays in shipping. This has resulted in additional stockholding pressures and backorders.”
A spokesperson from B Braun said production difficulties had led to a “temporary constraint” to supplies from their operations.