Without specifying what alternative material it will use, managed health-care provider Kaiser Permanente said it will no longer purchase intravenous-solution bags that are made from PVC or contain the plasticizer DEHP, or IV tubing that contains DEHP.
The company said the switch is designed to protect “the health and safety” of the 8.9 million people — 73 percent of whom live in California — who get care at its hospitals, doctors' offices and health-care facilities.
The transition will take place over the next six months. Kaiser, which buys 4.9 million IV tubing sets and 9.2 million solution bags annually, claims the switch will save the company almost $5 million a year.
The switch, announced Jan. 19, is expected to be a boon for material suppliers and medical-device companies that have developed non-PVC and phthalate-free IV products over the last several years.
Six years ago, the two companies that control 90 percent of the IV bag market in the U.S. — Hospira Inc. of Lake Forest, Ill., and Baxter International Inc. of Deer Park, Ill. — began selling non-PVC IV bags.
It's estimated that more than 300 million IV bags are used annually in the U.S.
“Kaiser is not doing its diligence on material switching,” said Allen Blakey, vice president of industry and government affairs for the Vinyl Institute, which represents four of the five largest vinyl resin and PVC producers in the U.S.
Alexandria, Va.-based VI argued that PVC and DEHP, or di(2-ethylhexyl) phthalate, “have some 50 years of safe use in myriad products such as blood bags [and] IV tubing,” and that the Food and Drug Administration “found no instances of harm from decades of use” in a 2002 study of medical products made flexible with DEHP.
“Kaiser ... announced that it would switch ... to an unnamed alternative, without offering either evidence of harm from PVC/DEHP or comparative information about the health and environmental impacts of the alternative,” said VI.
Kaiser only said that PVC and DEHP “have been shown to harm humans and [do] environmental harm,” without citing any specific data or studies, and added that research suggests “long-term exposure to DEHP ... can [result] in a variety of hormonal abnormalities, particularly in infants.”
That's the same approach Kaiser Permanente took in 2010 when it switched from PVC to nitrile rubber for the more than 40 million hospital gloves it buys annually.
When pressed by VI back then to provide life-cycle data to support that switch, Kaiser's vice president of workplace safety and environmental stewardship officer, Kathy Gerwig, told VI — in a letter dated April 12, 2010 — “we don't have unlimited resources to undertake the research ourselves on all the products we purchase.”
She added, “[But] where there is credible evidence that a material we're using may result in environmental or public-health harm, we strive to replace it with safer commercially available alternatives.”
That, too, is similar to what Kaiser said in announcing that it would no longer use PVC tubing and IV bags.
“We at Kaiser Permanente recognize that the products we buy can have a direct effect on human health and the health of our environment,” said Raymond Baxter, senior vice president for community benefit, research and health policy, in a news release announcing the change.
“Our efforts to remove harmful chemicals from hospitals and clinics reflect our commitment to the total health of our members and our communities.”
Kaiser Permanente, with headquarters in Oakland, Calif., has stated that it wants to “move the industry to create greener products” through its size and influence. Since May 2010, for example, companies that supply products and medical equipment to Kaiser have been required to provide environmental data for those items.
In addition, Kaiser is one of five companies — which combined buy $130 billion worth of medical products for hospitals and health-care facilities — that adopted a standard set of questions last fall for suppliers to answer about a variety of chemicals contained in products.
“Kaiser Permanente recognizes we can improve health today and for the future by taking a close look at the products we purchase,” said Barry Brenner, vice president for medical sourcing.