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Hospitals Deal With Shortage Of Life Saving Medication

Health care professionals at Oakland County hospitals – like others across the nation – are battling a dangerous shortage of a versatile medicine essential to treating immune disorders and other diseases.

The continuing, and confounding, shortage of immune globulin – with antibodies harvested from plasma – has provoked rationing and an intricate logistical response similar to how hospitals and health care facilities manage resources for disasters and extreme weather.

“It’s a big problem,” said Annette Karageanes, director of pharmacy, system operations for Beaumont Health. “It impacts a lot of patients in many ways.”

Intraveneous immune globulin (IVig) contains an antibody to help patients with weak immune systems due to underlying diseases, such as cancer, HIV/AIDS, lupus and infections, she said. Demand has increased dramatically in recent years, outstripping available supplies.

Hospitals and other medical systems have taken steps to monitor and prioritize distribution and use, according to the Food and Drug Administration. Increasingly, the product is targeted for patients who need it to stay alive and is rationed, suspended or withheld from patients with non-life-threatening conditions.

“We are aware of the nationwide shortage and have put a variety of measures into place to minimize impact to patient care,” Henry Ford Health System said in a statement.

At Beaumont, Karageanes said, some two dozen medical staffers huddle each week to set priorities.

“It’s a tedious process and we have to micromanage our supplies to meet patient needs,” she said. “It’s a process that requires a lot of communication and touches the health system throughout Southeast Michigan.”

Similar action has been taken by hospitals across the nation. In Massachusetts, for example, Massachusetts General Hospital responded to the immunoglobulin shortage by activating its Incident Command System, normally used for disasters like the Boston Marathon bombing and weather emergencies.

Dr. Teena Chopra, professor of infectious diseases at the Wayne State School of Medicine, said immune globulin “has been a lifesaver” for a variety of patients.

Among those are patients afflicted with myasthenia gravis, a condition that causes weaknesses in some muscles. There is no cure for the disease, which causes profound fatigue and typically affects those reaching middle age. Immunoglobulin helps block an immune system’s destruction of muscle cells.

“For this and other disorders, IVig is essential,” said Chopra, a director on the medical staff at the Detroit Medical Center.

For some patients, there is no suitable substitute for treatment.

Shortages of immune globulin have persisted as the medical community has determined its use for a growing number of ailments. Manufacturers say they need increased collections of plasma to expand production of plasma-based medicines. Industry officials said it can take seven to 12 months to produce and supply immune globulin.

The number of plasma collection facilities nationally has more than doubled in the past decade, to 737 facilities, but is insufficient to meet demand, said Patrick Schmidt, chief executive of FFF Enterprises, a national supplier of pharmaceuticals.

Donations have grown to 49 million liters from 15 million liters, he said. Of those donations, he said, about half is shipped out of the United States.

“’The bottom line is that we do need more plasma,” Schmidt said.

The Oakland Press

For nurses wanting to learn more about Gamma Globulin therapies, consider our online continuing education course All About Gamma Globulin

This instructional course has been designed to provide current conceptual and operational knowledge to the licensed nurse interested in the provision of gamma globulin therapy. The understanding and use of gamma globulin has evolved since its entry into mainstream healthcare. For both the RN and LPN/LVN involved in providing this therapy, this course contains current practices for best patient outcomes.

This course is based on the current best practices as defined by the Infusion Nursing Society and other governing agencies such as the CDC, and FDA.


Upon completion of this course, the participant should be able to:

1. Names at least three conditions for which gamma globulin is indicated
2. Demonstrate understanding of gamma globulin administration by recognizing the steps involved in its preparation and infusion
3. Recognize at least two side effects of gamma globulin infusion


Chapter 1
Introduction to Gamma Globulin

Chapter 2

Chapter 3
Possible Adverse Events
Common Side Effects
Uncommon Side Effects

Chapter 4
Patient Education
Nurse Administration
Patient Administration

Chapter 5
Assessment and Documentation
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