Supplies of essential chemotherapy drugs are running low — and experts fear the situation could soon lead to rationing of cancer-treating medications, according to a report.
Doctors across the U.S. are seeing shortages due to shipping delays, manufacturing problems and some companies discontinuing medications, The New York Times reported, citing the Food and Drug Administration.
There’s a shortage of ifosfamide, an injection used to treat sarcomas, lymphomas and testicular cancers, prompting doctors to make tough decisions about which patients to treat with the medication.
“There are some individuals who won’t be able to receive this drug, even if it is the best option for them, which puts pharmacists, doctors, patients and families in a horrific situation,” Dr Andrew Shuman, a head and neck cancer surgeon, told The Times.
Dr Shuman, who practices in Michigan, says that doctors are giving the doses of the medication that are available to patients who are likely to see the biggest benefit. This means younger patients with a full chance of recovery are being prioritized, according to the report.
Premier, a company that negotiates discounts on drugs for hospitals and cancer clinics, has seen only 38 percent of their orders filled for ifosfamide.
Additionally, only about two-thirds of cisplatin, a drug to treat ovarian, testicular and bladder cancers, has been filled, according to the company’s vice president of integrated communications, Amanda Forster.
Instead of rationing, some medical practices have started spacing out the time between doses. Other doctors are scheduling patients in consecutive appointments to ensure no medication is wasted.
Medical professionals have also had trouble securing several older chemotherapy drugs, including carboplatin, cisplatin and oxaliplatin.
“These three drugs remain the backbone of many cancer therapies,” Dr. Lucio Gordan, the president of the Florida Cancer Specialists and Research Institute, told The Times. These drugs are used to treat lung, ovarian, head and neck, testicular, breast and colon cancers.
A spokesperson for the Department of Health and Human Services told The Independent that it is aware of the shortage of ifosfamide and concerns regarding the supply of cisplatin and carboplatin.
“The agency is actively working with manufacturers and other stakeholders to help mitigate the impact of the shortage and support patient access to treatment. This includes engaging with manufacturers to understand supply constraints, identifying opportunities to increase available supply and helping to facilitate actions that may alleviate the shortage as quickly as possible, including potential temporary importation, where appropriate, to help bridge supply gaps,” the HHS spokesperson said.
The drug shortages are being felt across the globe. In India, regulators have raised price caps to account for the growing cost of platinum, which is needed to make the drugs carboplatin and cisplatin. Meanwhile, regulators in Europe have warned that supplies of the injection, ifosfamide, may not return to normal levels until next year.
Three years ago, two chemotherapy drugs, carboplatin and cisplatin, went into a months-long shortage in the U.S., prompting some cancer centers to switch medications or delay care.
At the time, the FDA allowed some foreign-approved versions of cisplatin to be imported into the U.S.
