A growing shortage of mainstream cancer treatments is forcing doctors to switch drugs and delay some treatments, prominent US cancer centers say.
The National Comprehensive Cancer Network said on Wednesday that almost all centers were affected interviewed late last month were struggling with shortages of carboplatin and cisplatin, two drugs used to treat a variety of cancers. Some are no longer able to treat patients receiving carboplatin at the intended dose or schedule.
dr Kari Wisinski had to resort to other treatments for some patients or change the order in which patients received their drug combinations. She said she did so “with the hope that within three months there will be a better supply of carboplatin.”
“As a doctor, it’s really difficult to have those conversations with a family or a patient about a drug that you’re trying to prescribe for them that isn’t available,” she said.
Wisinski is a breast cancer specialist at the UW Health Carbone Cancer Center in Madison, Wisconsin, a member of the network. She said the doctors, nurses and pharmacists at her center did a good job managing the supply of medicines but were distracted from other elements of care.
Of the 27 cancer centers that participated in the network’s survey, 25 reported a lack of carboplatin. Of cancer centers with carboplatin shortages, more than a third said they were unable to treat all patients on the intended dose and schedule.
Nineteen hospitals also reported cisplatin shortages, but all said they were able to maintain treatments for existing patients.
The problem started developing earlier this year, said Mike Ganio, who studies drug shortages at the American Society of Health-System Pharmacists.
“I think it went from a deficiency to a really bad deficiency very quickly,” he said. “There’s not much room for it to get any worse.”
Ganio’s company reported shortages of cisplatin in January and then carboplatin in late March, months after a factory in India that makes both drugs shut down production after an inspection raised quality concerns.
Production problems, unexpected spikes in demand and scarce ingredient supplies have all contributed a growing number of prescription drug shortages in the United States. Many patients with attention-deficit/hyperactivity disorder have had a hard time filling prescriptions for Adderall this year, and drugstores ran out of children’s medication during last winter’s cold-and-flu season.
According to the University of Utah’s Drug Information Service, there were 301 active statewide drug shortages in the first quarter of this year.
The US Food and Drug Administration has taken some steps to alleviate the lack of chemotherapy. The agency allows the temporary importation of some foreign-approved versions of cisplatin from FDA-registered factories.
That should help, but the big factor is getting the factory in India back up to speed, Ganio said.
He also pointed out that drug shortages have been a problem for decades.
“We really need to get to the bottom of the causes of these bottlenecks, otherwise they will continue to occur,” he said.
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