Hospitals are facing a shortage on medications that are used every day.

The situation is getting worse, the American Hospital Association said.

In particular, hospitals are facing shortages of commonly used IV fluids, including sodium chloride, dextrose, and nutritional solutions.



The US has a drug shortage problem.

In the wake of Hurricane Maria, a number of facilities that make healthcare products including intravenous fluids that are commonly used in hospitals have been knocked out of service.

That's led to shortages at hospitals around the US that are getting worse, according to the American Hospital Association, which represents thousands of hospitals and health systems.

"We are concerned that the shortages of widely-used and critical products are quickly becoming a crisis and looming threat to the public’s health," Thomas Nickels, executive vice president of government relations and public policy at the AHA, wrote to the FDA.

The American Society of Health-System Pharmacists (ASHP), an organization that monitors drug shortages, lists 139 compounds that are currently facing shortages.

In particular, hospitals are feeling the pain over a few commonly used IV fluids, including 50 and 100 milliliter injection bags of sodium chloride (also known as saline) at .9%, dextrose 5%, and nutritional solutions. All of these fluids are key in keeping patients hydrated and energized.

To get around the shortage, the AHA said, hospitals are using pill versions when possible, switching to versions that can be injected with just a syringe, and prioritizing some patients over others.

How drug shortages happen

The ASHP cites a number of reasons for the shortages. Most are related to manufacturing problems. In the cases of saline and dextrose, Baxter's facilities in Puerto Rico were hit by the hurricanes, adding to existing drug shortages.

In other cases, some of the companies which make large portions of the drug simply stop making it, or a drug is only being produced by a single manufacturer.

And therein lies the problem: There simply are not enough companies making the drug to keep up with demand.

It's all part of a consolidation of the manufacturers who produce generic drugs.

US generic companies have had a harder time turning a profit on generic drugs while competing with companies outside the US that are able to make the same drugs at a cheaper cost. That's caused manufacturers to home in on certain generic drugs and discontinue others that don't make as much money. And if a generic manufacturer has a shortage, there's no easy fix — you can't just pass off the job to another company while the first fixes its problems, since getting approval to take on a new drug can take years.

When it comes to this particular shortage, the AHA said in its letter that it would like the FDA to push manufacturers that make these drugs to invest in creating more supplies in the future, as well as find suppliers within the US that aren't as susceptible to natural disasters. The FDA said it will respond directly to the AHA regarding its letter.

"However, in general the FDA has an important role to play in working with companies to address product shortages that disrupt patient access to medical products, and we have been closely working on a number of efforts related to the current IV fluids shortage, which actually dates back to 2014, but was recently worsened by Hurricane Maria’s impact on Baxter manufacturing facilities in Puerto Rico," an FDA spokeswoman told Business Insider. "The FDA understands the concerns and importance of the ongoing shortages of IV solutions and we are actively working within our regulatory authority to address the shortage."