Since mid-January, the nurses at the Coastal Cancer Center in Myrtle Beach, South Carolina, have been spending several hours each week tracking down suppliers who can provide the intravenous (IV) solutions necessary for patients scheduled to receive chemotherapy. If they are unsuccessful, Vijay Paudel, MD, an oncologist at the facility, is faced with the onerous decision of which patients will get their treatments and who will have to wait.

鈥淭he bottom line is that patients end up not getting treatment,鈥� Paudel said. 鈥淲e are fortunate it hasn鈥檛 happened much, but once is too much.鈥�

Normally, securing the week鈥檚 IV fluids takes the cancer center鈥檚 nurses about half an hour, but a nationwide shortage that began in January has made the task a day-to-day or week-to-week challenge for oncology practices, hospitals, and other health care facilities across the country. The 2 companies that supply the bulk of the nation鈥檚 IV fluids attribute the shortage to increased demand caused by a difficult influenza season. But many in the health care industry question whether economic and other factors are the real drivers of the shortage.