Some Washington hospitals are rationing medical tests and rethinking procedures after a shortage of a critical drug hit the western United States.
Iodine contrast, a drug used in computed tomography (CT) scans, is in short supply, according to health care organizations in western Washington.
CT scans, which combine multiple X-ray images into one 3D-like image, are used to diagnose and monitor the health of bones, blood vessels, and soft tissues. They are used to assess internal injuries, diagnose cancer, and plan medical procedures.
“CT scanning is the workhorse of healthcare delivery,” said Dr. Dushyant Sahani, professor and director of radiology at the University of Washington School of Medicine. “All important decisions require it.”
UWMC performs around 1,000 CT scans a week, he said. The majority use the contrast in shortage.
The shortage of contrast stems from production stoppages at factories based in Shanghai, China, operated by pharmaceutical company GE Healthcare. Factories have been temporarily closed due to COVID-19 shutdowns ordered by the Chinese government. While factories are reportedly back in full production, the shutdown has led to a shortage that could affect hospitals until July.
Sweden’s Providence system, which includes Providence Saint Peter’s Hospital in Olympia, said its contrast reserves were at “critical” levels. GE supplies approximately 97% of its contrast medium with iodine.
WHY CONTRAST IS CRUCIAL
About 60% of CT scans use a contrast agent which is used to differentiate organs and detect lesions. The same iodine contrast is used in other procedures such as angiograms.
It is usually administered intravenously.
The shortage seems to have caught medical institutions off guard. UW learned of the shortage on Friday. Providence Swedish informed its staff of the shortage on Wednesday.
GE controls the majority of the contrast market in the United States. Hospitals that contract for a drug usually use only one supplier. This can be a problem if the supplier is out of a particular medicine.
Virginia Mason Franciscan Healthcare (VMFH), the parent company of Saint Joseph Medical Center in Tacoma, said it was aware of the shortage but was unaffected.
“We maintain an adequate supply through our manufacturer, Bracco, to meet the needs of our patients,” VMFH said in a statement Thursday.
Medical imaging specialist TRA also uses Bracco as a contrast supplier and does not expect a shortage, according to spokesman Chris Coates. In addition to its own facilities, TRA manages imaging for the Carol Milgard Breast Center in Tacoma.
UNIVERSITY OF WASHINGTON
In the six days since the shortage was revealed, Sahani and her colleagues developed strategies to reduce the need for contrast and avoid a crisis.
“How do we save enough contrast media (for) the critical departments and the patients who deserve it the most?” Says Sahani. “We can prioritize them and change our policy around patients who don’t need them as much.”
Heart and emergency department patients are prioritized over patients who might need a CT scan for a routine cancer checkup, he said.
UWMC is also using more dual-energy CT scanners, a cutting-edge technology that uses less contrast without compromising image quality, Sahani said.
Providence Swedish estimated that its current supplies would only last a week with normal use.
“We have begun transferring resources between hospitals as needed,” the health system said in a statement. “Our supply chain management division is working tirelessly to acquire additional contrast for our hospitals.”
On Wednesday, Providence Swedish temporarily suspended all non-emergency outpatient CT contrast scans.
Uptake is necessary to preserve contrast in strokes, trauma, cancer diagnoses, and heart and lung conditions.
However, patients should not hesitate to seek medical attention due to the shortage, Providence Swedish said.
“We ask our community not to delay or postpone urgent or emergent care,” he said.
This story was originally posted by The newsstand.
©2022 Cox Media Group