They Got Cancer. Then Their Drugs Were Rationed.
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Across the U.S., a monthslong shortage of critical chemotherapies including carboplatin and cisplatin have forced doctors and pharmacists to stretch their supplies. Some patients have received less treatment or lengthened the time between treatments, while others have had to turn to second-line options.
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Up to 500,000 U.S. patients could be at risk of having their treatment disrupted, according to Dr. Julie Gralow, chief medical officer at the American Society of Clinical Oncology. The organization and other medical groups have released guidance to help doctors manage. The chemotherapies in shortage are cheap, generic drugs that don’t make much profit—and few companies want to manufacture them. After the Food and Drug Administration found quality problems late last year at a major manufacturing facility in India, the company halted its production of cisplatin and carboplatin, sparking the scarcity.
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At least two dozen patients at the University of Cincinnati Cancer Center have had their treatment disrupted, said Dr. Davendra Sohal, an oncologist who treats gastrointestinal cancer patients and is Vencill’s doctor. Those already in clinical trials or who can be cured take priority when rationing the drugs, he said, followed by those with progressing disease. Some patients who are dealing with more stable, chronic disease have had to miss a dose in order to manage the supply, he said. A patient who travels weekly from West Virginia for treatment made the trip last month to find out that there wasn’t any drug, Sohal said. A few weeks ago, only half of the colorectal cancer patients could get their scheduled dose.
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A survey of 27 cancer centers found that 93% reported a carboplatin shortage and 70% have cisplatin shortages, according May data from the National Comprehensive Cancer Network. The centers said they could still treat the patients who needed cisplatin, but only 64% said they could keep all their patients who need carboplatin on the go-to regimen. Earlier this month, the FDA allowed imports of foreign-approved cisplatin from a Chinese drugmaker to help ease the shortages. The U.S. subsidiary of the Indian manufacturing plant that sparked the crisis has started to release some supply, an FDA official said.
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I think that we should offer an incentive to pharmaceuticals here to manufacture some of these generic "don’t make much profit." Without getting into the the whole issue of drug manufacturing and their prices. Just go ahead and do it.
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