A bipartisan group of U.S. senators, recently wrote a letter to the Federal Trade Commission urging them to investigate a potential breach of antitrust law over the production of saline, which has been identified by the Food and Drug Administration on the nation’s drug shortage list since 2013.
Erin Fox is Director of the Drug Information Service at University of Utah Healthcare, and she specializes in drug shortage management. She said the hospital has to make accommodations to adapt to the saline shortage, because it is the most commonly used fluid in the medical field. They began using smaller bags of saline, instead of the more common one liter bag.
“We were able to work with our nursing staff to only use a smaller bag, and we really managed through the shortage well that way," she said. " In other cases there are patients that they would just start a bag of saline on a patient, just as a precaution, and they might not actually need fluid. We were able to really conserve and minimize the impact for patients. ”
Saline production is dominated by three majors companies, Baxter Healthcare, Braun Medical and Hospira. There have been allegations of fraudulent behavior regarding the production of saline from these companies.
In their letter to the FTC, Sens. Orrin Hatch and Mike Lee joined with Richard Blumenthal from Connecticut, and Minnesota’s Amy Klobuchar, they wrote:
“Price increases often help clear shortages, but in this case the shortage is still ongoing after nearly two years, raising questions about the incentives of the saline suppliers to solve this problem and about possible coordination among them.”
In helping address the saline shortage at the U of U medical center, Fox said she has some sense as to why more companies haven’t tried to infiltrate the saline market.
“The products are usually cheap and so there is not a lot of profit margin, so there’s not a lot of incentive for new companies to go in and get into the market, and because these factories are running at capacity, they don’t have any back up plans or redundancy in their manufacturing, so when they have a problem their line just stops,” she said.
By informing the FTC about possible anti-trust violations the senators hope to encourage the federal government to find ways to end the shortage of saline.