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Supply chain woes hit hospitals, forcing Missouri to alter pharmacy rules

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Closeup of Emergency Room signage of the entrance of hospital

Emergency room signage (

JEFFERSON CITY — Missouri officials took steps this week to address a supply chain bottleneck affecting the availability of a chemical used by hospitals when CT scans are conducted.

In an emergency rule filed Monday, the Missouri Department of Commerce and Insurance gave pharmacies more latitude in how they handle and package Iohexol, which is used to help doctors get a clearer view of what is occurring inside a body during a diagnostic scan.

The rule change came after a June 1 meeting with state officials and representatives of the Missouri Hospital Association, which asked for assistance in ensuring the availability of the fluid.

The shortage is being blamed on COVID-19 lockdowns in Shanghai, China, which is where much of the supply is manufactured.

“Absent emergency action, MHA indicated Missouri hospitals and healthcare providers may not have adequate supply of iodinated contrast media to treat critical Missouri patients,” the emergency rule said. “Absent an emergency rule, Missouri patients may not be able to receive critical lifesaving care/treatment.”

GE Healthcare, which produces the material, told the U.S. Food and Drug Administration in May that the Shanghai production facility is beginning to ramp up production as COVID-19 lockdowns begin to ease. The company said it moved some production to a plant in Ireland and has begun shipping the product via air instead of relying on slower ocean vessels.

“However, normal production is not expected to resume until late June,” the FDA said in a release.

“This shortage once again points to the need to improve the resilience of the supply chain so that urgently needed care for patients is not interrupted,” the American Hospital Association said in a statement.

In Missouri, the MHA said some hospitals have reported up to an 80% decrease in available quantities.

“As a result, the Missouri Board of Pharmacy finds there is an immediate danger to the public health, safety and/or welfare and a compelling governmental interest that requires this emergency action,” the emergency rule notes.

After the COVID-19 pandemic triggered a break in the global supply chain, Gov. Mike Parson created a task force in November 2021 to review ways to develop solutions to address the issue.

The panel’s 79-page draft report includes 33 recommendations, ranging from investments in freight to improving support for workers who need child care, affordable housing and public transit.

The emergency rule is set to be in effect through Dec. 17.

Posted at 2:30 p.m. Wednesday, June 8.


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