Some hospitals in Washington are rationing medical scans and rethinking procedures after a shortage of a critical drug has struck the western United States.
Iodine-based contrast, a drug used in computerized tomography (CT) scans, is in short supply, according to health care organizations in Western Washington.
CT scans, which combine multiple X-ray images into a 3D-like image, are used to diagnose and track the health of bones, blood vessels and soft tissues. They are used to assess internal injuries, diagnose cancer and plan medical procedures.
“CT is the workhorse for care delivery,” said University of Washington School of Medicine professor and radiology chair Dr. Dushyant Sahani. “All important decisions require that.”
UWMC performs about 1,000 CT scans a week, he said. The majority use the contrast in short supply.
The contrast shortage comes from production shutdowns at Shanghai, China-based factories operated by pharmaceutical company GE Healthcare. The plants were temporarily closed due to COVID-19 lockdowns ordered by the Chinese government. While the plants are reportedly at full production again, the shutdown has resulted in a shortage that could affect hospitals into July.
Providence Swedish system, which includes Olympia’s Providence Saint Peter Hospital, said its stores of contrast are at “critical” levels. GE provides approximately 97 percent of its iodine-based contrast.
WHY CONTRAST IS CRUCIAL
About 60 percent of CT scans use a contrast agent which is used to differentiate between organs and detect lesions. The same iodine contrast is used in other procedures such as angiograms.
It’s usually administered intravenously.
The shortage seems to have caught medical institutions off guard. UW learned of the shortage on Friday. Providence Swedish notified its staff of the shortage on Wednesday.
GE controls the majority of the contrast market in the U.S. Hospitals that contract for a drug generally only use one supplier. That can be a problem if the supplier comes up short with a particular drug.
Virginia Mason Franciscan Healthcare (VMFH), the parent of Tacoma’s Saint Joseph Medical Center, said it was aware of the shortage but wasn’t impacted.
“We are maintaining adequate supply through our manufacturer, Bracco, to meet our patients’ needs,” VMFH said in a statement Thursday.
Medical imaging specialist TRA also uses Bracco as its contrast supplier and is not expecting a shortage, according to spokesperson 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 became known, Sahani and his colleagues have been strategizing to reduce the need for contrast and avoid a crisis.
“How do we save enough contrast media (for) mission critical services and patients who deserve most of that?” Sahani said. “We can prioritize those and change our policy around those patients who don’t need as much.”
Cardiac and emergency department patients are being prioritized over patients who might need a CT scan for a routine cancer check-up, he said.
UWMC is also using more dual energy CT scans, a state of the art technology that uses less contrast without compromising image quality, Sahani said.
Providence Swedish assessed that its current supplies will last just one week at normal use.
“We have begun shifting resources between hospitals as need arises,” the health-care system said in a statement. “Our supply chain management division is working tirelessly to acquire additional contrast for our hospitals.”
On Wednesday, Providence Swedish put a temporary hold on all non-emergency outpatient CT contrast scans.
The hold is needed to preserve contrast for strokes, trauma, cancer diagnosis as well as cardiac and lung conditions.
However, patients should not hesitate to seek medical care due to the shortage, Providence Swedish said.
“We are asking our community to please do not delay or postpone urgent or emergent care,” it said.
This story was originally published by The News Tribune.
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