A research team at Massachusetts General Hospital in Boston, Massachusetts, detailed their facility’s strategy for addressing the recent shortage of heparin in a report published in The Oncologist.1

In their report the researchers explained that the active ingredient in heparin is sourced from pigs, which have been affected by an outbreak of African swine fever (ASF) occurring in China. This outbreak has led to the slaughter of millions of pigs and driven the recent scarcity of heparin.

The ASF-induced heparin shortage triggered the Massachusetts General Hospital to arrange a task force to develop a strategy around heparin needs and usage. The task force initiated a conservation and waste reduction approach to heparin utilization. This involved preparing a tiered model for prioritizing the use of heparin based on indication and outlining alternative therapies that could be used in specific circumstances. Additionally, operations involved in the purchasing and distribution of heparin across the facility was streamlined to within a single department.

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The researchers found that prior to implementation of their program, heparin was used in 35.3% of patients requiring oral or parenteral therapeutic anticoagulation. Heparin use was reduced to 24.2% of these cases after implementation of the conservation approach during the shortage. For parenteral chemoprophylaxis, heparin was used in 46.5% of cases initially and in 16.2% with utilization of the conservation strategy implemented during the shortage.

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The researchers reported that there was an 80% overall reduction in the usage of heparin within 2 months of creating the task force.

“Although we are a large tertiary academic hospital with numerous resources and a well-developed emergency management infrastructure, we encourage other hospitals that do not have the same construct to modify our strategies to fit their needs,” wrote the researchers in their report.


Rosovsky RP, Barra ME, Roberts RJ, et al. When pigs fly: a multidisciplinary approach to navigating a critical heparin shortage [published online March 10, 2020]. Oncologist. doi:10.1634/theoncologist.2019-0910