IV fluid supplies still a concern for rural GPs

GPs in rural areas remain concerned about the supply of intravenous (IV) fluids in the face of ongoing shortages affecting medical professionals around the world.
 
Wagga Wagga GP and former RACGP Rural Chair Associate Professor Ayman Shenouda said the issue is ongoing after the alarm was raised earlier this year, despite efforts to find alternative supplies.
 
‘It’s starting to ease, but it’s still not a solution,’ he told newsGP.
 
‘For doctors to manage securely, they need not one bag or two bags, they need to have a stock where they feel like they have enough back-up.’
 
According to a newsGP poll that ran until early August, around 40% of respondents said their practice had been affected by the shortage.
 
Associate Professor Shenouda said GPs in remote areas need to have a reliable supply, giving the example of treating patients involved in an accident, or with diabetic ketoacidosis or pancreatitis.
 
‘Especially in rural and remote areas where GPs have to resuscitate patients to get them ready for transfer, this is an essential fluid,’ he said.
 
‘The majority of rural doctors would do that work, and so it’s essential for them to manage their work.
 
‘I respect what’s been happening and that people are trying to sort out this problem, but the last thing we want is doctors and patients to be vulnerable and not having necessary treatment at a time of really desperate need.’
 
According to the Therapeutic Goods Administration (TGA), shortages affecting three Australian suppliers will remain ‘throughout 2024’.
 
It lists 14 IV fluids from overseas suppliers it has approved under section 19A of the Therapeutic Goods Act 1989, which allows alternatives to registered medicines if they are in short supply.
 
The TGA says it is ‘continuing to prioritise evaluation of additional applications submitted under section 19A’ and attributes the shortage to ‘global supply limitations, unexpected increases in demand, and manufacturing issues’.
 
However, RACGP President Dr Nicole Higgins said the use of IV fluids by wellness companies has increased the pressure on health professionals needing them for medical treatments.
 
‘Every drop counts, we need to make sure that these resources go to where it’s needed the most,’ she told the ABC on Thursday.
 
‘IV fluids are really important for essential healthcare, but they are now being used as a business opportunity, which means they’re being used by some wellness companies for hangover cures, for delivering vitamins, which really makes very expensive urine.
 
‘Using it for pseudo-medical wellness causes … is just not a good use of resources at this time.’
 
Concerns have been raised about celebrities and social media influencers unnecessarily using IV fluids, fuelling a multi-billion-dollar global industry.
 
The Australian Health Practitioner Regulation Agency (AHPRA) has previously warned businesses about advertising IV infusion treatments without scientific evidence.
 
‘Clinics charging hundreds of dollars for cocktails promising everything from boosting immunity, clearer thinking, beauty, and even anti-aging, need to be honest with their clients about the lack of scientific evidence supporting their infusion services,’ AHPRA CEO Martin Fletcher said in 2022.
 
‘Patients also need to be aware of infection and other risks which come with all medical treatments, and which is why clinical interventions should only be provided when they are necessary.’
 
According to Nine Newspapers, there has been a sharp uptick in the number of registrations for infusion companies over the past five years in Australia.
 
The TGA has said it is unable to stop the purchase and use of IV fluids by wellness companies.
 
In August, the Federal Government announced it had secured more than 22 million extra IV fluid bags to be used over six months, including both local products and imports.
 
‘This supply volume exceeds the forecast demand over this period,’ a media release stated at the time.
 
Since then, the manufacture of IV fluids has been hit overseas, with flooding from Hurricane Helene forcing a temporary shutdown in production at a major manufacturing plant in the United States.
 
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AHPRA fluid industry IV medicine rural shortages TGA wellness