"For the most part, we're able to use an alternative. You can [stretch supplies] for a long period of time, but if you run out of product, you can find an alternative that works for the patient," he said.
Still, the widespread saline shortage can be more than inconvenience. It can drive up costs. Some providers, particularly small and rural community hospitals, may not have a pharmacy resources to formulate alternatives and have fewer options for sourcing alternatives.
Root Cause Analysis
"The question I'd like answered is, why is this happening?" says Jaspan. "I can't get a straight answer from anyone as to why this is occurring. We had adequate supplies until five months ago.
"I read through one [pharmaceutical] company's letter—they blamed the shortage on flu season. But the flu wasn't that big [of a problem] here," he said.
Bona E. Benjamin, director of medication-use quality improvement with the American Society of Health-System Pharmacists (ASHP), has another theory. She believes the saline shortage is rooted in product recalls.
"Most saline solution used in the US comes from one of three big pharmaceutical firms. There is one other supplier that is significant as well. Of the three firms, two [had] recalls of saline solution in late 2013. [The other] announced that they had a routine maintenance shut down. With the recalls and [manufacturing] shutdown, that strained the supply. Additionally, one more supplier from Europe that supplies saline solution for dialysis had an import delay from their plant in Mexico, which shifted demand to US suppliers," explained Benjamin.