Widespread drug shortages force doctors to make tough decisions on how to treat patients. This includes rationing dosages and switching to other treatments that may have more side effects.
The Food and Drug Administration has listed 14 cancer medications as being in short supply.
FDA Commissioner Dr. Robert Califf said to NBC News that the oncology shortage was a critical issue. “I am a former intensive care doctor and I know the consequences of not being able to get chemotherapy.”
Carrie Cherkinsky, right, was traveling in Australia in March when she started experiencing severe abdominal pain. Doctors discovered a mass on her right ovary that she later learned was cancer.
Courtesy Carrie Cherkinsky
According to a report released by the Senate Committee on Homeland Security and Governmental Affairs in March, drug shortages have reached record levels. Between 2021 and 20,22, the number of new drug shortages rose by almost 30%. At the end of 2022 there were 295 active drugs shortages, a five-year record.
“I can’t think of a worse time than this,” said Julie Gralow. She is the chief medical director and executive vice-president of the American Society of Clinical Oncology. What’s different is that this shortage is a result of the wide applicability of the drugs and their importance, both globally and in the U.S.
One of the drugs that are in short supply, is carboplatin. This chemotherapy agent is used as a primary treatment for many cancers.
“Carboplatin has a great deal of importance in the treatment of a variety of cancers, including lung cancer and ovarian cancer ,” said Dr. Lucio GORDA, medical oncologist and President of Florida Cancer Specialists and Research Institute. This is a network that includes cancer clinics. Gordan stated that they had been out of the drug completely for almost two weeks.
I’ve been doing it for over 20 years. “This is the worst thing I’ve seen,” he declared.
Florida Cancer Specialists were aware of the impending shortage and prepared. In the past couple of months they have been rationing carboplatin doses by rounding them down by 10%. Gordan says this doesn’t affect the efficacy of the drug.
He said, “We’ve been rounding for quite some time.” “But we ran out of drugs so there is nothing to round.”
Carrie Cherkinsky of Tallahassee in Florida, 41, found out about the shortage through a Facebook group for women who have ovarian carcinoma. She was still shocked when she learned that her second round chemotherapy scheduled for May 15 at Florida Cancer Specialists would not be available. Gordan did not take part in her care.
Cherkinsky was diagnosed with ovarian carcinoma in March. “For me not receiving the lifesaving therapy?”
Carboplatin has fewer side-effects and is less toxic than other drugs.
Dr. Angeles Alvarez Secord is the president of the Society of Gynecologic Oncology.
Secord explained that “if there is more toxicity in the drug, the cost of the treatment increases because you have to deal with side effects or give additional drugs to prevent side effects.” “So, the alternatives, despite being available, do not always meet the highest standard of care.”
Cancer care has forced hospitals and cancer centers across the country to take similar decisions.
According to a survey conducted in May by the Society of Gynecologic Oncology (SGO), doctors in atleast 40 states are in need of at least one chemotherapeutic drug.
News about the drug shortage
The shortages of breast and gynecologic oncologists at Valley Health System, New Jersey are devastating, according to Dr. Eleonora TEPLINSKY.
Teplinsky stated that “Cancer can be a life-changing disease, but as a patient you expect to be treated with the best available treatment.” “And at the moment, we do not have all of the best treatments available for certain cancers.”
Not only do drug shortages stress out cancer patients but also medical professionals. Doctors are already stressed out by a workforce who is exhausted due to a pandemic. Now they have to rush to find life-saving treatments.
Gordan stated that “all the practices across the country, and not just in oncology have been stressed much more since Covid.” This is yet another curveball which hinders us from doing the best that we can.
Sometimes shortages can catch providers by surprise.
Andrea Iannucci is the assistant chief pharmacy at UC Davis Health. She said that suppliers don’t warn customers when a drug will be short-supplied. They simply stop fulfilling all orders. Iannucci explained that when an order is placed, the supplier will not deliver it because it was unavailable.
Keri Carvill of Sacramento, California was diagnosed in March with Triple-Negative Breast Cancer but didn’t receive her first carboplatin dose until May 19th. Triple-negative cancer of the breast is an aggressive form.
Carvill stated, “It is stressful and frightening.”
What caused the shortage, and how can it be fixed?
Experts say that the current carboplatin supply shortage is a result of quality issues at Intas Pharmaceuticals in India. However, they also believe it to be a more chronic problem.
Califf stated, “Unfortunately the profitability of this sector is low or nonexistent.” “Many firms are either going out of business or having quality issues because they can’t invest in their technology.” This is the main reason behind the shortage we are seeing.
In a press release to NBC News Intas Pharmaceuticals stated that it was working with FDA to release the existing stock of carboplatin as well as other medically essential products. Intas Pharmaceuticals is also working on a plan with the FDA to resume production, but has yet to confirm a specific date.
Califf stated that the FDA is working to increase carboplatin availability by working with other manufacturers.
He said that long-term solutions will require “intervention from Congress and the White House to get this industry into the right place,” adding that the White House has been working to address the drug shortage problem.
Teplinsky, an oncologist from New Jersey, has encouraged her social media fans to contact their elected officials and advocate for the timely production of chemotherapy drugs as well as long-term policies that will ensure this does not happen again.
Teplinsky stated that “delaying care has an impact on outcomes.” In this case, we either can’t provide what people need or we must wait, and we know that will have negative consequences. Follow NBC HEALTH Twitter & Facebook.
