Over the past 3½ years, Dorothy Schwaninger has been on chemotherapy to battle ovarian cancer.
Treatment went well until her oncologist's office called with surprising news. She would need to postpone her appointment because the doctor couldn't get the drug she needs.
“I've never heard of such a thing. I thought that can't be right,” said 82-year-old Schwaninger, of Yukon.
Schwaninger is among the growing number of cancer patients caught up in a nationwide chemo drug shortage that a doctor says will lead to an epidemic of avoidable deaths.
“The gains in the curable malignancies have resulted from a hard-fought war, and now it is particularly galling to see the slow, steady and continued emergence of a national travesty — the shortage of cytotoxic drugs, which will certainly lead to an epidemic of avoidable deaths,” Dr. Derek Raghavan, president of the Levine Cancer Institute in Charlotte, N.C., writes in the Sept. 1 issue of The American Society of Clinical Oncology Post.
A total of 17 mainstay drugs used in chemotherapy are currently in short supply, said Mike Cohen, president of The Institute for Safe Medication Practices.
“The shortage is pretty severe right now. It's pretty scary,” he said.
Dr. Shubham Pant, oncologist with the Peggy and Charles Stephenson Oklahoma Cancer Center, said health care providers have to be agile to deal with the toughest year he's ever seen for chemotherapy products. He said the absence of needed drugs has forced the center to put patients on alternative drugs and postpone clinical trials.
“We deal with the shortage of one drug and then we deal with the shortage of another drug. It's been kind of one drug after another,” he said.
Keith Madison, pharmacy director at Mercy Health Center and a pharmacist for more than three decades, agreed.
“I think the overall shortage of pharmacy products is most significant. In my years I've never seen an overall shortage of products like this. Specifically to oncology products, it's very significant,” he said. He said Mercy has been fortunate to be able to meet the drug demands of its 1,200 cancer patients yearly.
Shortage is difficult
For Schwaninger, the volatile supply has resulted in her chemotherapy being postponed three times, including once this week. Her doctor, who has her on chemotherapy every 21 days, told her she'll be fine if the drug arrives as expected next week. If not, she'll need to begin an alternative drug. That's not a simple proposition.
Pharmacist Erin Fox oversees a shortage-tracking program at the University of Utah. “That's what makes a chemo shortage very difficult. These aren't easy drugs to switch out like Legos,” she said.
Quality and manufacturing issues are the major reasons behind the shortages, according to the Food and Drug Administration. Other reasons include raw material supply problems, increased demand, limited number of manufacturers for some drugs and drug companies' decisions to stop manufacturing older drugs in favor of newer, more profitable drugs.