A report from the American Society of Health-System Pharmacists (ASHSP) shows a growing number of vital chemotherapy drugs are in short supply. Paclitaxel (brand name: Taxol), a drug used extensively in patients with colon, lung, breast and ovarian cancers, has been added to a list of 196 other major drugs considered to be in short supply. The drugs on the shortage list include anesthetics, antibiotics, pain medications and chemotherapy drugs for leukemia.
Cynthia Reilly, director of the ASHSP’s practice development division, called the shortages a “public health crisis”. “There are cancer patients who will die because of this (shortage),” Reilly said. “This could change their survival.” The shortage also extends to many generic drugs, which offer a cost-effective alternative for patients over the brand-name prescriptions. Some chemotherapy drugs, such as cytarabine and daunorubicin for leukemia, are also in short supply and do not have effective substitutes.
The shortage has forced some hospitals and cancer centers to select which patients have greater need for their life-saving medication. Dr. Michael Link, a pediatric oncologist at Stanford University’s Lucile Packard Children’s Hospital, said that the shortage in leukemia medication has put him and his staff at risk of making some difficult choices. “We’re hoping to get more so we don’t face that awful crisis. Other practices have.”
The lack of available medications has become a nationwide problem, but the shortages have disproportionately affected smaller facilities. According to Dr. Link, several patients have had to drive to other states to get the medication they need. He noted that larger facilities and hospitals that have access to multiple suppliers tend to have less of an issue with shortages, but smaller treatment centers and oncology practices “tend to operate more on an order-as-needed basis.”
Even the bigger hospitals are not immune to these shortages. The MD Anderson Cancer Center in Houston, Texas, one of the largest cancer treatment facilities in the country, reported that their stockpiles of at least four different chemotherapy drugs are at severely depleted levels, with another twenty also in short supply. The Cancer Therapy and Research Center at the University of Texas Health Sciences Center in nearby San Antonio reported “rationing the use of” paclitaxel.
Some hospitals are taking emergency measures to insure that they have an adequate supply of paclitaxel on hand. The Beaumont Hospital in suburban Detroit is currently paying more than three times its normal rate for paclitaxel. At the Ochsner Clinic Foundation and Hospital in New Orleans, doctors work together to move available drugs from one physician’s patient to another’s in greater need. Dr. Jay Brooks, Ochsner’s chairman of oncology, said that he had never seen shortages this severe in his 25-year career in cancer treatment.
A spokesperson with the US Food and Drug Administration (FDA) said that some of the makers of generic-label paclitaxel have some of the drug on hand and that the shortage was “not a complete national outage”. One paclitaxel supplier, Bedford Laboratories of Bedford, Ohio, announced that they had numerous backorders for the drug. A spokesman announced that the company hopes to have a supply of the drug ready for market by 1 July.