Four U.S. senators are asking the Federal Trade Commission to investigate possible collusion by saline solution suppliers to deliberately exacerbate a shortage of the solution to drive up costs, according to The Wall Street Journal.
The senators sent a letter Monday to FTC Chairwoman Edith Ramirez stating saline suppliers may have illegally inflated prices to exploit a shortage of the solution, which is a staple at all hospitals.
Here are seven things to know about the issue, according to WSJ.
1. The letter — which was signed by Richard Blumenthal (D-Conn.), Amy Klobuchar (D-Minn.), Mike Lee (R-Utah) and Orrin Hatch (R-Utah) — said prices for saline have gone up by 200 to 300 percent since a shortage began in 2013.
2. Saline is commonly administered to patients intravenously to hydrate them or to dilute medicines. Last year, the FDA said the shortage was a serious threat to patients.
3. The FDA attributed the shortage to rising demand by hospitals. To alleviate the shortage, it allowed some manufacturers — including B. Braun Medical and Baxter International — to temporarily import saline from foreign factories. The three biggest saline suppliers for the U.S. are Baxter, B. Braun and Pfizer's Hospira unit, according to the report.
4. Baxter disputed the claims that it had raised saline prices by the amounts specified in the senators' letter. A Baxter spokeswoman said the average U.S. price for Baxter's one-liter saline solution has increased annually since 2013. Increases have ranged from single- to low double-digits on a percentage basis. Additionally, Baxter said it has attempted to increase its supply, according to the report.
5. Pfizer said Hospira expanded its production of saline solutions when the shortage was first noted in 2013, adding the solutions are "one of healthcare's greatest values" at current prices. WSJ couldn't reach a B. Braun spokesperson for comment.
6. "While all three companies have publicly spoken to their commitment to ending the saline shortage, it has persisted for two years even as prices have risen," the senators wrote in their letter, according to the report. They contend that while prices typically rise during a shortage, "these price increases appear to be outside the bound of natural market forces."
The letter also claims the saline suppliers impose even higher price increases on customers that don't buy other products from them, such as tubes and catheters through which saline is administered to patients, according to the report.
7. The saline supply has improved this year, though the shortage persists, Erin Fox, director of the University of Utah Health Care's Drug Information Service told WSJ. Shortages of saline often force physicians to delay treatments or administer suboptimal alternatives to treat diseases. Many shortages originate from manufacturing problems, according to the report.