GE Contrast Media Shortage (Omnipaque and Visipaque) – American College of Radiology Guidance
The American College of Radiology (“ACR”) has issued a statement on GE’s global contrast media shortage including considerations for alternative diagnostic imaging. It is anticipated that the shortage, largely caused by supply chain issues related to the recent COVID-19 lockdown in China, will begin improving within the next couple weeks. However, the FDA reports full stock is not expected until July 2022. Rationing may continue until then and a surge in imaging may occur shortly thereafter due to delayed studies. The ACR guidance can be located here: ACR Statement on Drugs and Contrast Media.
This shortage may impact groups with diagnostic imaging centers and interventional procedural areas. Prior to implementation or altering of process to address the shortage, we suggest working with your practice leadership, physicians, radiology staff/experts and your vendor to develop a plan that upholds patient safety, diagnostic imagining necessity and stewardship of supply.
The ACR suggests the following risk mitigation strategies:
- Utilize alternative studies to answer the clinical question such as non-contrast CT, MR with or without gadolinium-based contrast media, ultrasound with or without ultrasound contrast agents, nuclear medicine, or PET/CT, when feasible. Please refer to the ACR Appropriateness Criteria® guidelines for indicated alternative studies as needed. Scroll down to AC Portal and use the “Explore by scenario” icon.
- Look for alternative versions of contrast agents, which may be marketed under a different brand name or intended clinical use. Note: U.S. market availability may differ from global availability.
- Source contrast from other vendors, if able, and consider having at least two vendor products on formulary. *Bracco, Bayer and Guerbert are alternative distributors and/or manufacturers of iohexol and iodixanol.
- If you currently have access to higher volume single-use vials, work with a sterile compounding pharmacy to determine if it is possible to repackage vials in smaller aliquots to reduce waste.
- Minimize individual doses administered to reduce waste. Some options include:
- Weight-based dosing for CT in available aliquots/vial sizes to avoid waste.
- Reducing dose in conjunction with low kVp protocols that improve contrast conspicuity.
- Reducing dose and acquire studies with dual-energy protocols (where available) that improve contrast conspicuity.
- Reserve higher concentration (mg iodine / ml) agents for angiographic studies and multiphase studies, which require optimal vascular visualization.
Additional considerations:
- Do not sacrifice image quality by using suboptimal doses; ensure enough contrast dose is used for diagnostic image quality.
- Consider partnering with other institutions for urgent/emergent studies should the supply levels at the practice not be sufficient.
Your Ortho Risk Partners risk consultant is available to you for questions related to risk mitigation strategies:
Julie Jines
[email protected] or (618) 223-9596
Other resources that may be helpful during this time are linked below:
AHA Advisory – Shortage of Contrast Media
FDA Drug Shortages: Omnipaque (iohexol) and Visapaque (iodixanol)
