text: 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. 
   
   Further Reading 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. ||||| PEORIA — A national shortage of a common drug is prompting hospitals to conserve their supply for only the most necessary applications. 
   
   While The New York Times has reported that a shortage of sodium bicarbonate has forced some hospitals to delay chemotherapy treatments and operations or send patients across town, both OSF HealthCare and UnityPoint Health-Peoria say that in light of the shortage, the hospitals have been conservative with their supplies without resorting to such drastic measures. 
   
   "Our supply has been trickling in, and we are maintaining critical operations," said Rhonda Georgieff, manager of pharmacy supply chain operations at OSF. "We are just experiencing major delays and back orders, or order that may come in only partially filled." 
   
   While sodium bicarbonate solution is a simple drug — sodium bicarbonate in its solid form is known as baking soda — its use in medicine is more complicated than restocking at the local grocery store. The solution, delivered via IV, must be sterile and of certain chemical composition. Only two suppliers in the United States offer the drug, and one is having production issues and the other isn't able to absorb the increased demand. 
   
   While the drug is simple, it's also critical to some hospital operations. It's used to lower the pH of blood that has become too acidic, in emergency and operating rooms, as an antidote to certain poisons, with certain types of chemo and to reduce pain, the Times reported. 
   
   But it's limited availability may be due in part to its affordability. Manufacturers don't bother with generic forms of cheap drugs like sodium bicarbonate, Georgeiff said. Combine reduced profit incentive for U.S. manufacturers with increased oversight of overseas manufacturers, and shortages are bound to happen. 
   
   Sodium bicarbonate is just one of dozens of drugs listed in shortage by the FDA and American Society of Hospital Pharmacists. Hospitals and pharmacies are well practiced in conserving medications in short supply, often without any noticeable change in operations as far as patients can tell. 
   
   "We expect this situation to continue for another month. Hopefully, not longer," Georgieff said. 
   
   Laura Nightengale is the Journal Star's health and lifestyle reporter. She can be reached at 686-3181 or lnightengale@pjstar.com. Follow her on Twitter @lauranight.
target: – The "simplest of drugs" is in short supply at hospitals around the country, causing crucial surgeries and other treatments to be reprioritized, and it's a cheap drug whose main ingredient may be found in your own pantry, the New York Times reports. That drug is sodium bicarbonate solution, aka baking soda, which is used in chemo regimens, as a poison antidote, and to help patients whose blood has veered into acidic ranges, among other uses. But the nation's two lone suppliers, Pfizer and Amphastar, are suddenly unable to give medical facilities what they need, causing those facilities to hoard what's left in their own cabinets. "Does the immediate need of a patient outweigh the expected need of a patient?" says the head pharmacist at a hospital in Mobile, Ala., calling it a "medical and ethical question that goes beyond anything I've had to experience before." Supply problems can arise when things go wrong at the factory level or when suppliers of the raw ingredients have issues, leaving hospital officials irritated at the short notice they receive about a dearth. Right now on the FDA website, there are dozens of drugs said to be "currently in shortage," many of them critical generic injectables. Some pharmacy officials even harbor suspicions that manufacturers aren't investing enough to ensure adequate supplies since, per Ars Technica, generic drugs aren't the moneymakers. Some hospitals have "compounding pharmacies" where they whip up their own generic drugs, but that doesn't solve the larger problem. "It is unbelievably frustrating," a University of Utah drug shortage expert tells the Times, which notes Pfizer and Amphastar can't guarantee more sodium bicarbonate supplies until at least June and maybe not until August in some cases. (The "cartels" some think control the market.)