Hospitals that rely heavily on imported products like face masks and exam gloves may be exposing themselves to potential supply disruptions in the event of a global pandemic or natural disaster, some materials management experts are warning. The issue has raised concerns about a repeat of the supply shortages many hospitals encountered during the 2009 H1N1 outbreak.

Mickey Sparrow, materiel manager for Tuomey Healthcare System, a 300-bed hospital in Sumter, S.C., says his hospital had difficulty maintaining an adequate supply of N95 masks during the H1N1 outbreak. In part, Sparrow says, the lack of domestic production of those products made it difficult to react to the crisis. A recent report from the Premier health care alliance found that more than 90 percent of all face masks and exam gloves are manufactured overseas.

"During H1N1, we ran out of products," Sparrow says.

Concern has reached Washington, D.C. The Department of Commerce is studying the reliance on foreign manufacturers in the health care supply chain, according to Stephen Curren, deputy program manager for Health & Human Services' Critical Infrastructure Protection program. A formal study, which is expected to come out later this year, will evaluate key products and their projected availability in the event of a major disease outbreak or disaster.

"There are potentials for disruption from foreign sources of supply," Curren says.

Another pressure point is the unparalleled growth of the Chinese economy, and its emergence as both a producer of health care supplies and a consumer of raw goods, says Mike Alkire, president of Premier Purchasing Partners. That combination has the potential both to increase future supply costs and make it more difficult for U.S. providers to snag crucial supplies in the event of a global health crisis, Alkire says. For instance, Premier reports that China now produces two-thirds of the world's aspirin and 70 percent of its penicillin.

"We've never had a population of that size develop at this pace," Alkire says. "The pressure this puts on raw goods will continue to evolve as China's needs continue to change."

To prepare their supply chains for future disasters and epidemics, Alkire suggests health care providers become more involved in sourcing to specification, which he argues could lower overall supply costs and make it easier for domestic suppliers to compete.

Annette Pummel, vice president of clinical operations for American Contract Systems, a contract packaging and sterilization vendor, suggests hospitals look into the disaster management plans of overseas producers before entering into contracts. Hospitals also should consider having plans in place for product substitution in the event a primary producer is unable to meet their needs, she adds.

"The risks can be minimized," Pummel says. "There's extra due diligence hospitals have to do to ensure their products will be available when the time comes."

Where Was It Made?

of all nutritional supplements, face masks, exam gloves, enzymes and amino acids are manufactured overseas.

of the world's penicillin and two-thirds of its aspirin are made in China.

$88 Billion
the amount of money spent in the United States in 2009 on medical supplies and equipment.

of surgical and medical instruments are imported.

49% Total
•17% of U.S. medical supplies and equipment come from Mexico.
•15% from Ireland
•9% from Germany
•8% from China