Brik V. Eyre
Analyst · Bank of America Merrill Lynch. Your line is now open
Yeah. Thanks Joe. Bob, let me talk about a couple of segments of the business. So first our small-volume parenterals. So these are 50-, 100-, 150-milliliter bags that are used to administer, infuse medication to patients. In that segment, when there were no products that our customers could find, about 25% of the doses that have historically been used or been administered through infusion using our MINI-BAG and MINI-BAG Plus products, had to find other ways to administer those drugs. A portion of that went through a new practice which is IV push. Now to be clear, IV push happens in every hospital every day across the country, typically in OR drugs, et cetera. But in this particular case when there was no product, specifically cephalosporins, penicillins, those anti-infectives were moved to an IV push. This practice is, the nurse literally takes a syringe and dilutes the drug into 5 ml, 10 ml worth of diluent and then injects it into a port that is at the hand where there's access to the vein. And then they will do that over a period of time. There are some safety concerns, et cetera, that we are talking with our customers, but some customers have moved to IV push. And in so doing, they have to change their protocol. They changed their protocol, they changed their system, et cetera. So while we do believe we will get this back, it's taking a little bit more time than we had anticipated. Other customers went to competitive products. We actually feel very confident that we will get those products back and we're working with our customers now to ensure that they understand that we have capacity, supply, et cetera. Now the other component of this is Nutrition that was impacted from the hurricane perspective. The Nutrition business actually did contract, the market contracted. Whereas Joe mentioned in the opening comments, when customers didn't have product, they delayed start times, et cetera. So believe the overall nutrition market has contracted about 7%. We have also lost some share, because we didn't have product and we are working again with customers to get that share back. So while we don't think it's a long-term piece, certainly over the next few quarters we anticipate seeing a ramp-up of bringing those products back to us. But anything that required a change in protocol will take a little bit more time.