Two Republicans and two Democrats on the Senate Judiciary Committee called on federal regulators to probe possible collusion by the three main suppliers in the market for saline, “a critical input to the United States healthcare system.”
Sens. Mike Lee (R-Utah), Amy Klobuchar (D-Minn.), Orrin Hatch (R-Utah) and Richard Blumenthal (D-Conn.) on Monday asked the Federal Trade Commission to investigate alleged antitrust violations by Baxter, Hospira, and B.Braun.
There has been a shortage of saline in the US since 2013.
“While prices tend to increase during a shortage, these price increases appear to be outside the bound of natural market forces,” the group of legislators said in a letter to FTC chair Edith Ramirez. “Price increases often help clear shortages, but in this case the shortage is still ongoing after nearly two years, raising questions about the incentives of the saline suppliers to solve this problem and about possible coordination among them.”
The senators noted hospitals have reported “all three saline suppliers” hiking prices on customers who don’t agree to additional purchase products to administer the solution.
“If true, these actions pose a potential risk to the wellbeing of patients by forcing hospitals to purchase products they may believe to be clinically inferior and add significant costs to our health care system,” the quartet stated.
The senators also said the shortage is being exacerbated by the three firms’ behavior, even if they’re not acting in concert. Their “ability to extract several-hundred-percent price increases and to lock their customers into long term contracts is likely reducing their incentive to alleviate this troubling shortage,” the senators said.
Sens. Lee and Klobuchar are the chair and ranking member of the judiciary subcommittee on antitrust. Hatch has presided over the Judiciary Committee for more than eight years during his almost-four-decade career in the Senate.
Some activists have said that anti-competitive behavior in the healthcare industry goes far beyond alleged infractions by saline suppliers, putting the blame for shortages of many commonly-used hospital products on group purchasing organizations (GPOs); firms, the activists say, that control hundreds of billions in contracts to thousands of hospitals.
“Five companies–MedAssets, Novation, Premier, HealthTrust and Amerinet–account for roughly 90% of contract volume,” Phillip Zweig, executive director of Physicians Against Drug Shortages and Dr. Robert Campbell, chair of the group in Pennsylvania, wrote in January.
“Last year, this crisis reached a new level of absurdity: the United States is now importing sterile saline solution (AKA salt water) from Spain and Norway,” they also stated. “GPOs have turned the once-robust US generic drug marketplace–indeed, the entire healthcare supply chain–into a vestige of the disgraced Soviet economic system.”
At least one Novation representative has denied the claims of Zweig and Campbell, saying that the saline shortage can be explained by Food and Drug Administration regulations on intravenous fluid manufacturers.
FDA officials have said the shortage is being caused by a spike in demand that plateaued, and a production process complicated by needs to ensure sterility.
