New Baxter leader facing questions about saline pricing, lingering issues over PD dialysate shortage

José Almeida has some homework to do before taking over as chairman and CEO of Baxter International in January. Almeida, 53, is replacing Robert Parkinson Jr., who is retiring after serving as the company's CEO for over 10 years. Almeida's appointment as chairman and CEO will take effect at the beginning of 2016.

Prior to joining Baxter, Almeida had been chairman, president and CEO of Covidien since 2012. He previously served as president of Covidien's medical-device business, which accounted for about two-thirds of the company's annual revenue and roughly three-quarters of its operating profit.

One item he will need to address is a request by U.S. Senators to have the Federal Trade Commission investigate whether Baxter and other companies colluded to control the supply of saline to keep prices high.

The bipartisan group of U.S. Senators say the U.S. has had a shortage of saline solution since 2013, and said the three companies that provide all of the saline solution in the U.S. — Baxter, Hospira, and B. Braun—have raised prices by 200-300%.

Debora Spak, a spokeswoman for Baxter, told Modern Healthcare that the average selling price of Baxter’s commonly prescribed one-liter sterile saline solution in the U.S. has increased annually at a modest level, in the single to low double digits – nothing like the amounts cited by the senators.

“The saline suppliers’ ability to extract several-hundred-percent price increases and to lock their customers into long term contracts is likely reducing their incentive to alleviate this troubling shortage, which, in turn, further exacerbates the shortage and results in consumer harm,” the Senators wrote.

Baxter has been in the spotlight in the past over product shortages. Investigators discovered the heparin being made in Chinese plants was contaminated, and one of the raw product suppliers had not been routinely inspected by the FDA. Baxter stopped manufacturing heparin because of reports of serious allergic reactions and hypotension in patients who receive high bolus doses of the drug. Four people died after receiving the drug. Baxter has not sold heparin vials since 2008 and divested its U.S. generic injectable drug business in early 2011.

Last August, Baxter announced it had underestimated the growth among its customers in the number of new patients being placed on peritoneal dialysis and had a shortage of dialysate. The company at the time said it could only provide enough product to meet current needs among patients on continuous cycling peritoneal dialysis. The company eased the shortage somewhat by importing dialysate from a plant in Ireland, collaborating with Fresenius Medical Care to offer that company’s dialysate product to Baxter customers, and plant expansion to produce more dialysate. Earlier this year, a survey completed by NN&I showed that the number of dialysis patients on PD was 3,000 less among the 10 largest dialysis companies than the previous year. -by Mark Neumann