{"id":12626,"date":"2023-05-31T05:21:51","date_gmt":"2023-05-31T10:21:51","guid":{"rendered":"https:\/\/ustower.net\/?p=12626"},"modified":"2023-05-31T05:21:53","modified_gmt":"2023-05-31T10:21:53","slug":"as-cancer-drug-shortages-grow-some-doctors-are-forced-to-ration-doses-or-delay-care-2","status":"publish","type":"post","link":"https:\/\/ustower.net\/?p=12626","title":{"rendered":"As cancer drug shortages grow, some doctors are forced to ration doses or delay care"},"content":{"rendered":"\n

Widespread shortages of cancer drugs<\/a> are forcing doctors to make difficult decisions about how to treat their patients, including rationing doses and turning to other treatment options with potentially more side effects.  <\/p>\n\n\n\n

As of Wednesday, the Food and Drug Administration listed 14 cancer drugs in shortage.<\/p>\n\n\n\n

\u201cThe oncology shortage is especially critical,\u201d FDA Commissioner Dr. Robert Califf told NBC News. \u201cI\u2019m a former intensivist doctor and I\u2019m very aware of the consequences if you can\u2019t get needed chemotherapy.\u201d<\/p>\n\n\n\n

According to a March report<\/a> from the Senate Committee on Homeland Security and Governmental Affairs, drug shortages are at record highs. New drug shortages increased by nearly 30% between 2021 and 2022. By the end of 2022, there was a record five-year high of 295 active drug shortages<\/a>. <\/p>\n\n\n\n

\u201cI don\u2019t know of a time that\u2019s worse than this,\u201d said Dr. Julie Gralow, the chief medical officer and executive vice president of the American Society of Clinical Oncology. \u201cWhat\u2019s different about this shortage is, I think, it\u2019s just the broad applicability of these drugs, how important they are, you know, globally, in the U.S., in the treatment of many diseases.\u201d  <\/p>\n\n\n\n

Among the drugs in shortage<\/a> is carboplatin, a chemotherapy agent used as a first-line treatment for a number of cancers.<\/p>\n\n\n\n

\u201cCarboplatin is such an important drug for the treatment of many cancers \u2014 breast cancer<\/a>, ovarian, head and neck, lung cancer, among several others,\u201d said Dr. Lucio Gordan, a medical oncologist and president of Florida Cancer Specialists and Research Institute, a network of cancer clinics. Gordan said they were completely out of the drug for nearly two weeks. <\/p>\n\n\n\n

\u201cI\u2019ve been doing this for 20-plus years. This is the worst I\u2019ve ever seen,\u201d he said.<\/p>\n\n\n\n

Florida Cancer Specialists knew that the shortage was coming and tried to prepare. For the last couple of months, they\u2019ve been rationing by rounding down doses of carboplatin by 10%, which Gordan said doesn\u2019t diminish the drug\u2019s efficacy. <\/p>\n\n\n\n

\u201cWe have been rounding down for a while,\u201d he said. \u201cBut we just ran out of the drugs, so there\u2019s nothing to be rounded.\u201d<\/p>\n\n\n\n

Carrie Cherkinsky, 41, of Tallahassee, Florida, learned of the shortage from a Facebook support group for women with ovarian cancer. Even so, she was shocked to learn that she wouldn\u2019t be able to get her second round of chemotherapy, scheduled for May 15, at Florida Cancer Specialists. Gordan was not involved with her care.  <\/p>\n\n\n\n

\u201cWho\u2019s going to be held accountable for this?\u201d said Cherkinsky, who was diagnosed with ovarian cancer in March. \u201cFor me not getting the lifesaving treatment?\u201d<\/p>\n\n\n\n

Carboplatin isn\u2019t just an effective drug; it\u2019s also less toxic and causes fewer side effects than other available drugs.<\/p>\n\n\n\n

\u201cOne of the issues though with these alternative medications is often they\u2019re not as good, so it may compromise survival outcomes,\u201d said Dr. Angeles Alvarez Secord, president of the Society of Gynecologic Oncology. <\/p>\n\n\n\n

In addition, \u201cwhen there\u2019s more toxicity, there\u2019s more cost to the treatment because you\u2019re also dealing with the side effects, or giving additional drugs to try to prevent the side effects,\u201d Secord said. \u201cSo the alternatives often, even though they\u2019re present, are still not meeting the best standard of care.\u201d<\/p>\n\n\n\n

Nationwide, hospitals and cancer centers have been forced to make similar decisions when it comes to cancer care.<\/p>\n\n\n\n

According to a May survey conducted by the Society of Gynecologic Oncology, doctors in at least 40 states have at least one chemotherapy drug in shortage.<\/p>\n\n\n\n

Dr. Eleonora Teplinsky, a breast and gynecologic medical oncologist at Valley Health System in New Jersey, said the shortages are devastating.\u201cCancer is life-changing as it is but you expect as a patient that you\u2019re going to walk into an office and be given the very best that exists,\u201d Teplinsky said. \u201cAnd right now we don\u2019t have the very best to give in certain cancers.\u201d<\/p>\n\n\n\n

Drug shortages cause extra stress not only for cancer patients, but for medical providers as well. On top of being in a workforce that\u2019s already burned out and exhausted<\/a> from a pandemic, doctors have to scramble to find lifesaving treatments. <\/p>\n\n\n\n

\u201cAll the practices in the country, not only in oncology, we have been stressed out much more since Covid,\u201d Gordan said. \u201cThis is another curveball that impedes us to do the best we can.\u201d <\/p>\n\n\n\n

Shortages can sometimes catch providers off guard.<\/p>\n\n\n\n

Suppliers don\u2019t give warning when a drug is about to be in shortage; they\u2019ll just stop filling all of their orders, said Andrea Iannucci, the assistant chief pharmacist at UC Davis Health. \u201cSo we place an order, and we think it\u2019s going to arrive and it doesn\u2019t, because the drug was unavailable,\u201d Iannucci said. <\/p>\n\n\n\n

Keri Carvill, 44, of Sacramento, California, was diagnosed with triple-negative breast cancer<\/a> in March but wasn\u2019t able to get her first dose of carboplatin until May 19. Triple-negative breast cancer is a particularly aggressive form of the disease.<\/p>\n\n\n\n

\u201cIt\u2019s stressful and scary,\u201d Carvill said.<\/p>\n\n\n\n

What led to the shortage and what can fix it?<\/strong><\/strong><\/h2>\n\n\n\n

The current carboplatin shortage was caused in part by quality concerns at one manufacturing facility, Intas Pharmaceuticals, in India, but experts say the real problem is more chronic. <\/p>\n\n\n\n

\u201cUnfortunately, the profitability of this industry is very low or nonexistent,\u201d Califf said. \u201cA number of firms are going either out of business, or they\u2019re having quality problems because of difficulty investing in their technology. That\u2019s the core underlying reason for the shortage that we\u2019re seeing.\u201d<\/p>\n\n\n\n

In a statement to NBC News, Intas Pharmaceuticals said it is working with the FDA to release existing inventory of carboplatin and other medically necessary products. It is also working with the agency on a plan to resume manufacturing, but added that a date has not yet been confirmed for when that will happen.<\/p>\n\n\n\n

Califf said the FDA is working with additional manufacturers to make more carboplatin available. <\/p>\n\n\n\n

Long-term solutions, however, are going to require \u201cintervention by Congress and the White House in order to get this industry in the right place,\u201d he said, adding that a White House team has been working on the drug shortage issue.<\/p>\n\n\n\n

Teplinsky, the oncologist in New Jersey, said she\u2019s been encouraging her social media followers to reach out to elected officials to advocate for timely production of chemotherapy drugs and long-term policies to ensure this doesn\u2019t happen again. <\/p>\n\n\n\n

\u201cDelaying care impacts outcomes,\u201d Teplinsky said. \u201cAnd so in this case, either we can\u2019t give people what they need, or we have to wait, which we know will lead to negative consequences.\u201d<\/p>\n\n\n\n

nbcnews<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Widespread shortages of cancer drugs are forcing doctors to make difficult decisions about how to treat their patients, including rationing doses and turning to other treatment options with potentially more side effects.   As of Wednesday, the Food and Drug Administration listed 14 cancer drugs in shortage. \u201cThe oncology shortage is especially critical,\u201d FDA Commissioner Dr. Robert Califf […]<\/p>\n","protected":false},"author":7,"featured_media":12627,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5784],"tags":[7622,1286,7440,7621],"class_list":["post-12626","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-cancer-drug-shortages","tag-doctors","tag-food-and-drug-administration","tag-treatment-options"],"_links":{"self":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/12626","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=12626"}],"version-history":[{"count":1,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/12626\/revisions"}],"predecessor-version":[{"id":12628,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/posts\/12626\/revisions\/12628"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=\/wp\/v2\/media\/12627"}],"wp:attachment":[{"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=12626"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=12626"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ustower.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=12626"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}