| TO: |
Florida Hospital Chief Executive Officers, Chief Medical Officers, Emergency Managers and Government Relations Executives
|
| CC: |
Supply Chain, Pharmacy, and Emergency Management Contacts |
| FROM: |
Mary C. Mayhew, President and Chief Executive Officer, Florida Hospital Association |
| SUBJECT: |
Follow-up: Radiologic Studies Contrast Media Shortages |
| DATE: |
May 12, 2022 |
Dear Florida Hospital and Health Systems:
FHA is aware of national supply shortages of radiologic contrast material for imaging studies. On April 19, GE Healthcare notified its customers of a supply disruption of the Omnipaque product lines caused by a COVID-19 lockdown imposed by Chinese health authorities on their manufacture facility in Shanghai. GE has indicated this shortage will impact hospital operations through June 2022 but stressed that supply should begin improving after May 23. FHA members have expressed concern about this most recent disruption and asked FHA for assistance in sharing key data, information, guidance, and resources to help facilities in their efforts to conserve and allocate supply where needed.
FHA has received multiple reports from members that Isovue (Iopamidol Injection), a contrast media alternative produced by Bracco, and imaging products produced by Guerbet, are also unavailable. Guerbet and Bracco are not currently accepting new customers due to supply constraints from the GE disruption.
FHA advises hospitals and health systems to work directly with your GE representative for assistance, additional recommendations, and options. The GE Healthcare Life Sciences Medical Affairs team is available to assist hospitals with their conservation efforts and answer questions. GE’s Medical Affairs team can be reached in the following ways:
1. Fill out a digital Medical Information Request Form
2. Email: [email protected]
3. Phone: 1-800-654-0118 (select option 2, then option 3)
On today’s FHA-hosted call, representatives from GE Healthcare, the American Hospital Association, and the Florida Department of Health shared the important information below for Florida hospitals’ clinical leaders and medical staff.
GE Healthcare - Greg Eppink, Contrast Media Lead for the US and Canada
- GE Healthcare is available to support hospitals and health systems as they work to return to full capacity as soon as possible.
- GE Healthcare understands the impact of disruption on your supply and is doing everything possible to mitigate availability issues.
- Patient care remains GE Healthcare’s number one priority. All actions in GE Healthcare’s action plan are about maintaining patient care.
- This is a temporary situation, caused by the lockdown in Shanghai. The GE Healthcare Shanghai plant is now operational and continues to work with local authorities to enable increasing numbers of operators onsite in compliance with local COVID-19 protocols.
- GE Healthcare is also exploring production capabilities out of the country of China and has quickly implemented production capability in their Cork, Ireland facility.
- GE Healthcare is singularly focused on resolving this supply shortage and appreciates the partnership and understanding of Florida’s hospital community.
- GE Healthcare cannot quantify exact allocation percentages as the volume coming into the country is fluid and the percentage allocation is also dynamic based on product availability and customer order patterns. But contingent on the historical run-rate, customers can expect a gradual ramp-up of allocation between now and the end of June.
- GE Healthcare is not pursuing a direct-only product purchasing program.
- They will continue to supply all wholesalers, at allocation, during this time.
- Although they are increasing production capacity weekly (based upon local regulations) in our main manufacturing centers, GE Healthcare does not anticipate that all stock-keeping units (SKUs) will be available during this time.
- GE Healthcare is making every effort to ensure there is equity in allocation of product.
American Hospital Association (AHA) - Mike Schiller, Senior Director, Supply Chain
- The Supply Chain Resource Council (SCRC) convenes supply chain and health care leaders from across the health care field to understand the extent and impact supply shortages and disruptions are having within the hospital and patient care settings, as well as a capturing and documenting solutions to these challenges. Information collected during these calls is drafted into a report and shared with AHA and AHRMM Leadership, the White House Response Team, various Federal Agencies, and the broader health care field.
- AHA is aware of the global shortage of IV contrast fluid and has raised this issue with the Administration, including with the White House, FDA, ASPR, and CMS. AHA is also sharing information with other stakeholders including national payer association leaders to ensure they are aware of the situation and the potential implications for the course of care.
- Roslyne Schulman, Director of Outpatient Payment, Emergency Preparedness and Response and Public Health Policy shares that while AHA has been told that the supply will be increasing through May with a return to normal stocking levels by the end of June, hospitals are exploring various conservation strategies including the use of other imaging technologies, other contrast agents, rationing contrast and ensuring efficiency in the use of contrast agents and postponing some less urgent scans to continue to provide needed care.
- AHA will continue to proactively provide hospitals and health systems with potential temporary solutions while also urging the government and other stakeholders to prioritize this issue.
Florida Department of Health - CDR Aaron Otis, Deputy Emergency Coordinating Officer, State ESF-8, Florida Department of Health
- FDOH and State ESF-8 will continue to work with FHA to stay informed of the situation.
- FDOH is monitoring this shortage to identify where they may be able to support hospital operations.
FHA has identified the following additional hospitals to consider:
- American Society for Health-system Pharmacists Current Drug Shortage Bulletin - Iohexol Injection – May 10, 2022
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- FDA drug shortage information for Iodixanol (Visipaque) Injection – May 9, 2022
- Statement from the American College of Radiology on Drugs and Contrast Media – May 6, 2022
- Supply Chain Resource Council Special Report, American Hospital Association – May 5, 2022
- GE Contrast Media Shortage and Conservation Strategies, Greater New York Hospital Association – May 4, 2022
- Shortage of iodinated contrast agent impacts the performance of CT scans, Vanderbilt University Medical Center – May 4, 2022
- Vizient Omnipaque drug shortage information sheet – May 3, 2022
FHA is aware hospitals are exploring various conservation strategies, monitoring, and allocating existing supply, and postponing elective procedures that can be delayed, to continue to provide needed care. Additional strategies for consideration include:
- Evaluate your orders for IV contrasted imaging to determine if alternatives are suitable; similarly, determine if alternate imaging modalities could be utilized.
- Expect that this may impact your practice in procedural areas.
- Ask radiology and procedural areas that utilize IV contrast to prioritize only essential urgent and emergent imaging/procedures and adopt mitigation strategies appropriate to the facility, given that this shortage is expected for at least eight weeks.
- Evaluate the amount of on-hand inventory of Omnipaque, and review plans for obtaining additional product.
- Seek other means of securing contrast media including alternate wholesalers and distributors but recognize that this is a nationwide issue and that alternative sources may not be available.
- Discuss protocol options with radiology leadership, radiology staff, and ordering physicians including Emergency Department physicians, cardiologists, and outpatient imaging providers to ensure protocols are evaluated for the appropriate use of contrast media.
- Transition ambulatory patients to non-contrast CT when feasible so that there will be more contrast for trauma and stroke patients presenting to emergency rooms.
- Where appropriate, consider adjusting scanning protocols to scan without contrast and injector protocols to reduce the amount of contrast dose.
- Communicate opportunities for conservation and awareness of wasted contrast media to CT, x-ray, interventional, and catheterization lab technologists.
- Develop a communication plan for referring physicians and all imaging departments; leverage appropriate use criteria for when to utilize contrast-based CT examination.
FHA is in regular communication with our state and federal partners, and other related groups to obtain and share current information and additional strategies to conserve contrast media during this time of shortage. Please contact John Wilgis, Vice President of Member and Business Relations at 850-524-2037 for questions and additional information.
Mary C. Mayhew
President and Chief Executive Officer
Florida Hospital Association