Hospitals around the country are scrambling to stockpile vials of a critical drug — even postponing operations or putting off chemotherapy treatments — because the country’s only two suppliers have run out.

The medicine? Sodium bicarbonate solution. Yes, baking soda.

Sodium bicarbonate is the simplest of drugs — its base ingredient, after all, is found in most kitchen cabinets — but it is vitally important for all kinds of patients whose blood has become too acidic. It is found on emergency crash carts and is used in open-heart surgery and as an antidote to certain poisons. Patients whose organs are failing are given the drug, and it is used in some types of chemotherapy. A little sodium bicarbonate can even take the sting out of getting stitches.

“As I talk to colleagues around the country, this is really a problem we’re all struggling with right now,” said Mark Sullivan, the head of pharmacy operations at Vanderbilt University Hospital and Clinics in Nashville.

Hospitals have been struggling with a dwindling supply of the medicine for months — one of the suppliers, Pfizer, has said that it had a problem with an outside supplier but that the situation worsened a few weeks ago. Pfizer and the other manufacturer, Amphastar, have said they don’t know precisely when the problem will be fixed, but it will not be before June for some forms of the drug, and in August or later for other formulations.</s>Hospitals are dealing with a shortage of sodium bicarbonate, a drug whose active ingredient is essentially the same one that cooks know as baking soda. Healthcare providers, which need the drug for uses that include heart surgery and chemo, are having to ration it right now because of supply issues reported by its primary producers, Amphastar and Pfizer.

“As I talk to colleagues around the country, this is really a problem we’re all struggling with right now,” Mark Sullivan, the head of pharmacy operations at Vanderbilt University Hospital and Clinics in Nashville, Tennessee, told the New York Times.

Providence Hospital in Mobile, Alabama, had to postpone seven open heart surgeries because of the shortage, officials told the newspaper.

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Amphastar is indicating it now has some supply available, but Pfizer said in a “Dear Customer” letter last week that it will be late June to sometime in August before it can provide clients with the simple but essential drug. It will be August into next year before it will have full recovery of supplies of some doses. In an email, a spokesman said the shortage is due to issues with a third-party supplier but not the API supplier.

Shortages of low-priced, stable drugs like sodium bicarbonate and saline solution have become a fact of life for hospital pharmacies. Often with just a few suppliers, if one has supply chain issues, increased demand can quickly overwhelm the inventories of other producers.

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In fact, Pfizer said in its letter last week, the shortage of sodium bicarbonate is one of eight it is dealing with right now. Also in short supply are Bicillin, labetalol hydrochloride, sodium acetate, calcium chloride, dextrose, atropine sulfate and epinephrine.

Pfizer told clients that the causes of individual shortages vary but the majority are due to three main factors: manufacturing, distribution, and third-party supplier delays.

Because of the supply-and-demand factors involved, when hospitals can get their hands on product from other producers, it comes at a much higher cost. That is what happened several years ago when a shortage of saline solution, another common but essential hospital product, plagued hospitals. In that case, however, hospitals got suspicious because there were a number of producers and ever-rising prices didn’t solve the supply issue. Some complained that producers were also tying sales of infusion supplies to availability of product.

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This all led to a congressional hearing and a federal investigation, with evidence now being heard by a federal grand jury. Baxter International, B. Braun and Hospira, now owned by Pfizer, are the major suppliers of saline. Pfizer and Baxter have reported that employees have been subpoenaed to testify before the grand jury. The companies have vigorously denied collusion and pointed to their efforts to increase supplies when the shortage materialized.

RELATED: Pfizer subpoenaed to testify in DOJ's antitrust probe of saline shortages

In the matter of the current shortages, Pfizer said that it has a “dedicated team focused on addressing these delays” and has taken eight steps to speed the recovery of supplies, including allocating some medicines to minimize stockouts, increasing production at key injectable plants and qualifying alternative third-party suppliers who meet the company’s standards.

As for hospitals awaiting supplies, it is more of the same, Kuldip Patel, the associate chief pharmacy officer at Duke University Hospital in North Carolina, told the Times: “It’s not like we haven’t been here before.”</s>Amid a national shortage of a critical medicine, US hospitals are hoarding vials, delaying surgeries, and turning away patients, The New York Times reports. The medicine in short supply: solutions of sodium bicarbonate—aka, baking soda.

The simple drug is used in all sorts of treatments, from chemotherapies to those for organ failure. It can help correct the pH of blood and ease the pain of stitches. It is used in open-heart surgery, can help reverse poisonings, and is kept on emergency crash carts. But, however basic and life-saving, the drug has been in short supply since around February.

The country’s two suppliers, Pfizer and Amphastar, ran low following an issue with one of Pfizer’s suppliers—the issue was undisclosed due to confidentiality agreements. Amphastar’s supplies took a hit with a spike in demand from desperate Pfizer customers. Both companies told the NYT that they don’t know when exactly supplies will be restored. They speculate that it will be no earlier than June or August.

As hospitals and pharmacists struggle with the sodium bicarbonate shortage, experts note that it’s just the latest example of stocks of inexpensive, essential generic medicines hitting alarming lows. For example, there was a sodium bicarbonate scarcity in 2012 and a similarly alarming shortage of saline solution in 2014.

Dangerous shortage of essential antibiotics is all about $$ Experts blame the shortages on a combination of factors, including problems getting raw materials, issues with aging facilities where many old drugs are manufactured, and consolidation in the industry that reduces the number of potential suppliers. There’s also the concern that because generic drugs are unlikely to drive profits, drug companies may not make necessary investments to maintain supplies.

But when there isn’t a steady supply, patients suffer. With the shortage of sodium bicarbonate, hospitals are postponing surgeries and chemotherapy treatments. A hospital in Mobile, Alabama, for example, postponed seven open-heart surgeries and sent one critically ill patient to another hospital due to the shortage.

The Food and Drug Administration is working with Pfizer and Amphastar to try to mitigate the effects of the scarcity. A spokesperson for the agency said that it is “exploring all possible solutions to this critical shortage, including temporary importation, to help with this shortage until it’s resolved.”

In recent years, the agency has been addressing the problem of shortages and has made progress. In 2011, there were 251 shortages, while there were only 23 in 2016. There are currently 50 drugs listed in short supply.</s>Dec 5 Pfizer Inc said on Monday its cancer drug, Bosulif, was found effective in a late-stage study on previously untreated patients with a form of blood and bone marrow cancer that is characterized by the abnormal production of white blood cells.

Most people with chronic myeloid leukemia (CML) have a genetic mutation, called the Philadelphia chromosome, which causes the bone marrow to make an enzyme that triggers the development of abnormal and unhealthy white blood cells.

Bosulif is already approved to treat adults with Philadelphia chromosome positive (Ph+) CML who are resistant or intolerant to prior therapy.

Pfizer said on Monday it would work with regulators to seek approval for the drug to be used on previously untreated Ph+ CML patients. (Reporting by Natalie Grover in Bengaluru; Editing by Savio D'Souza)
Because of a nationwide shortage of intravenous sodium bicarbonate (i.e., baking soda solution), United States hospitals are rationing its use in heart surgery, chemotherapy, for patients whose blood is too acidic, and as an antidote to certain poisons. The two primary producers, Amphastar and Pfizer, indicate that supplies will not increase until late June.