National Shortage of Cancer Drugs Puts Lives at Risk
A national shortage of essential cancer drugs has put the lives of over 100,000 cancer patients at risk, particularly women. The shortage has been caused by supply chain issues, with 14 cancer drugs in short supply in recent months. The drugs in shortest supply include cisplatin and carboplatin, platinum-based drugs used to treat gynecologic, breast, testicular, bladder, head and neck, and non-small cell lung cancers. The American Society of Clinical Oncology (ASCO) has been working to resolve the shortage and saw the first glimmers of hope last week after a national delivery of carboplatin, which has been in shortage for a month.
Shortage Causes Frustration and Fear
Elizabeth Arnold, a journalism professor at the University of Alaska and former reporter with National Public Radio, was recently diagnosed with advanced uterine cancer. Her surgeon said she needed chemotherapy to knock down the tumors before operating. But with key medications in shortage, she was told she would get five bags of the drug carboplatin, not the usual six. The nurse at her hospital in Anchorage, Alaska, said they would likely run out completely before her next treatment in three weeks. Arnold is caught up in a frightening and frustrating national shortage of essential drugs.
Alternative Approaches
Doctors can often give patients a different drug if one is in shortage. But cisplatin, which has been limited since February, is often used as a substitute for carboplatin and vice versa, so limited access to both creates problems. New guidelines from ASCO encourage doctors to stick to the lowest recommended dose and the longest accepted interval between doses. Some substitute therapies are just as effective as original ones but might require a different dosing schedule or carry more side effects.
Why These Cancer Drugs are in Shortage Now
Although cisplatin and carboplatin are manufactured by five companies, all rely on a single supplier in India that was shuttered over the winter for safety reasons. Though some production has resumed, deliveries are behind schedule and supplies are low. Demand, particularly for cancer drugs, keeps rising as patients live longer with their disease.
How to Fix the Problem
Structural changes are needed. Congress should add regulations to require data-sharing, offer incentives to protect the drug supply, manufacture more medications in the U.S. and create a stockpile of essential drugs. The U.S. government should use its buying power to encourage multiple manufacturers to make essential drugs, rather than focusing on the cheapest source and a “race to the bottom.”
