Global shortage of saline solution affecting Australian healthcare system
In short:
The Therapeutic Goods Administration says there is a shortage of multiple intravenous (IV) fluid products in Australia due to “manufacturing issues and unexpected increases in demand”.
Health departments in states and territories are conserving stock and using suitable alternatives.
What’s next?
The TGA says supply is expected to be limited throughout 2024.
Australian health services and veterinary clinics are conserving their stock of intravenous (IV) fluid or using alternative products amid a global shortage of saline solutions.
Sodium chloride, commonly known as saline, and sodium lactate solutions are administered intravenously to human and animal patients to treat or prevent dehydration.
The Therapeutic Goods Administration (TGA) said all states and territories were affected by the shortage of IV fluids.
“These are critical hospital medicines used in routine and critical care settings, as fluid replacement, for resuscitation, and to administer other IV medications,” a TGA spokesperson said.
“These shortages are a global issue and are due to manufacturing issues and unexpected increases in demand.”
A TGA spokesperson said all three Australians “sponsors” — Baxter Healthcare, B. Braun and Fresenius Kabi — have indicated their products are in shortage and “supply will continue to be constrained” for the remainder of the year.
“To improve supply, the TGA has allowed the importation and supply of multiple overseas-registered alternative saline fluids, and has further applications for supply under consideration.
“The TGA is regularly advising state and territory health departments of new suppliers approved to import overseas products to allow them to make orders.
“The TGA is also liaising with Baxter, B Braun and Fresenius Kabi to monitor the situation and address any regulatory barriers to supply.”
States and territories respond to shortage
NSW Health issued a safety alert flagging the “critical disruption” to the supply of IV fluid bags.
It recommended administering alternative methods of treatment where appropriate, such as oral fluid replacement, as well as reviewing its stock to prioritise the supply of IV fluids to clinical areas of high usage.
A Queensland Health spokesperson said it had formed a dedicated working group to support local hospitals during this “nationwide shortage” of IV fluids.
“The response includes a number of measures to navigate this supply disruption, including collaborating with suppliers and the Therapeutic Goods Administration,” it said.
An ACT government spokesperson said the ACT Health Directorate, Canberra Health Services, ACT Ambulance Service and private hospitals were working together to share stock as required.
A safety alert sent to SA Health staff this week recommended clinicians to conserve stock and “ensure judicious use”.
“Supply disruption is expected to be critical in the coming one to three weeks and whilst small and intermittent supplies may become available, is likely to continue for a number of months,” it said.
SA Health statewide incident controller Wayne Champion said it had “good levels” of saline available in public hospitals but is sourcing products domestically and from overseas.
“Despite national and global supply issues, we have adequate stock for immediate needs and have been assured that our orders will be fulfilled,” he said.
“Out of an abundance of caution, we are conserving stock to make sure the patients who need these products can receive them.”
“We have asked clinicians to use suitable alternatives for patients where it is clinically appropriate to do so.”
In a staff email seen by ABC, SA Ambulance Service has prohibited the use of saline solution for training and to preserve supply for patients.
The Australian and New Zealand College of Veterinary Scientists last month raised the issue of ongoing supply disruption to saline solution with the Australian Veterinary Association (AVA).
The AVA in its most recent update to members said it was “actively exploring” options, including support for initiatives to source IV fluids from overseas suppliers.
“The AVA is facilitating the progress of fast-tracking imported supplies, which involves navigating regulations and communicating with relevant stakeholders and authorities, a process that can take some time,” it said.
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