EDITORIAL: Time to take action to stop medical supply shortages

Jun. 10—America, the greatest industrial nation on Earth, should not have a baby formula shortage.

Yet the months-long scarcity of vital baby formula — used by nearly half of new mothers across the United States — highlights the brittle nature of the nation's medical supply chain.

How did we get here? In September of last year, an infant given formula made in Michigan by Abbott Nutrition was diagnosed with Cronobacter sakazakii, a potentially lethal bacteria.

Abbott, the maker of Similac, shuttered its facility and voluntarily recalled formula already on the store shelves. The move sparked a massive shortage that necessitated emergency measures by the federal government, including the importation of millions of cans of formula from overseas. While work at Abbott's Michigan plant has restarted, it will be months before the country has anything approaching a steady supply of formula.

It didn't have to happen. Yet it did, for the simple fact that Abbott controls more than 40% of the nation's formula market. When its operations shut down, its smaller competitors were not able to make up the difference.

If Abbott were the only broken link in the medical supply chain, it would be bad enough. But it is merely getting the most attention.

A nationwide shortage of contrast dye after a shutdown of a plant in China has led hospitals to ration the use of CT scans, which look inside blood vessels and arteries.

"For a radiologist who has been reading scans and always had (dye) contrast, to ask them to read without it, they will miss things," Dr. Eric Dickson, CEO of UMass Memorial Health, told the Boston Globe. "It's a horrible shortage. And it has significantly impacted operations. Ultimately we've had to do scans without contrast or withhold the scan."

Imagine a patient expecting a CT scan to detect a serious disease like cancer being told they have to wait or go without because a single plant overseas shut down.

"This shortage once again points to the need to improve the resilience of the supply chain so that urgently needed care for patients is not interrupted," the American Hospital Association said in a statement addressing the contrast dye shortage.

These efforts must include taking steps to encourage and strengthen domestic manufacturing and production in nearby countries, and to deepen the supply chain to enable continued availability of critical supplies and medications."

It's not just pricey items. Increasingly, generic drugs and commonplace medical equipment are found to be in short supply.

The COVID-19 pandemic normalized shortages of masks, gloves and other protective equipment. Other fairly simple tools — like saline solution and sodium bicarbonate — have been just as hard to acquire.

Of course, those simple tools don't cost much to make, and aren't as profitable for manufacturers. That leaves their production in the hands of relatively few companies — and leaves Americans vulnerable.

It's not all attributable to the pandemic. When Hurricane Maria hit Puerto Rico in 2017, it didn't just level the island. It also destroyed one of the few U.S. production centers of intravenous bags. Many hospitals, unable to provide patients with a saline drip, were forced to offer Gatorade instead.

There are currently more than 220 active drug shortages in the United States, and many of those shortages are due to the fact that often drugs are made by a single firm, or small handful of companies. It's a system that invites disaster. When Teva closed its California manufacturing facility last October after a major recall, it threatened to create shortages of up to 24 generic sterile injectable drugs, including five essential medications, according to an industry group.

It is clear Congress has work to do. It needs to force pharmaceutical companies to be more transparent about what drugs they are making and where, and it needs to require that those companies that make critical medications — and baby formula — have a contingency plan in case of a plant shutdown. And it needs to ensure there is a redundancy of "basic" products, such as IV bags and saline solution.

If the COVID pandemic has taught us anything, it's that America's medical innovation and manufacturing power mean nothing if lifesaving and life-sustaining products don't make their way to those who truly need them.