Crucial cancer drugs in critical short supply

(CBS News) 

Fighting cancer is hard enough, even with the best medical care.

Now imagine being a cancer patient and being told that the supply of a chemotherapy drug you need to survive has suddenly run out.

CBS News medical correspondent Dr. Jon LaPook reports that there is one California woman who doesn't have to imagine it. She's living it.

Marcia Goodman, 56, has ovarian cancer. She was supposed to get chemotherapy Wednesday, but her clinic just ran out of her medicine.

"I was just starting to feel hopeful this drug would work. My heart just sank," Goodman says.

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Her oncologist had prescribed Doxil, and said the drug had the best chance of controlling the cancer she's battled since 1998.

"You invest all your hope and belief in the drug that your doctor has chosen with you at the moment because clearly that's the one that everybody thinks will help you. And so if that drug is suddenly not available it's like a train that's suddenly left the tracks. You feel like its crashed," Goodman says.

Doxil is just one of nearly 200 chemotherapy drugs in short supply, like Cisplatin, used to treat testicular, ovarian and bladder cancers, and Paclitaxel, commonly used for ovarian & breast cancers. Many new cancer drugs are often made by single manufacturers, so any disruption can result in shortages.

"We're going through an unprecedented period of extreme shortage of many key therapies to treat cancer," says drug supply expert Adam Fein, who blames hoarding for being part of the problem.

"If there's a rumor of a drug shortage, every hospital and every doctor tries to get as much of that drug as they can," Fein says.

The company that makes Doxil recently issued alert of "production delays," and suggested new patients not begin treatment. But Goodman had already started. She cannot believe a drug shortage could now threaten her life.

"Chemotherapy keeps you alive. It's as simple as that," Goodman says.

Janssen, which makes Doxil, told CBS News the company is working closely with the FDA on a plan to get the drug to doctors as soon it becomes available. It expects the supply to improve in late August for the 7,000 people who use it.

Several doctors interviewed by CBS News say they are beside themselves at not having all the tools of their trade.

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Follow Dr. Jon LaPook and producer Amy Burkholder on Twitter at @DrLaPook and @AmyBurkCBSNews

[joykern]

Sorry to say, government is the problem

[tmn]

Actually, government may well end up being the solution to the problem...

[gpwhale]

I am so sorry to hear the news of what I call a terrible tragedy. I am a 6 year survivor of stage IV Breast Cancer wirh credit going to my well qualified Oncologists and the latest in chemo drugs. I am on my third round of chemo with every other week treatment since January/2011.

In addition a large corporation is threatening the shut down of our three cancer centers in the Dallas, Texas metroplex as of August 31, 2011. It is all so stressful for everyone concerned. More importantly it is life threatening for so many. Where is the human compassion for those of us who just want to continue living!

Gail wwwlivingbyhope.com

[adamjfein]

I am the "drug supply expert" quotes in the story.

If you are interested in learning about the many causes and some possible solutions to the drug shortage issue, then I recommend the Drug Shortages Summit Summary Report (www.ashp.org/drugshortages/summitreport).

The ASHP Drug Shortages Resource Center also has a lot of good info (www.ashp.org/shortages)

There is no one villain to blame for shortages, which makes the problem very difficult to fix.

[RXBuyer]

Thank you ASHP. I look at that often.

But I still do believe that the gray market is an underreported cause.

[adamjfein]

RX Buyer,

I discussed the gray market in the unaired portion of my interview, but it's a subtle issue for people outside the industry.

In this situation, Doxil is a sole source product with some sort of manufacturing issue. Here's Janssen's letter to providers that is mentioned in the story: www.doxil.com/sites/default/files/DOXIL_DHCP_letter_July2011.pdf

[RXBuyer]

I too am a hospital pharmacy buyer and am dealing with this problem every day. The number of critical drug shortages has steadily increased from 70 in 2006 to 211 in 2010. This year they are expecting it to jump to 350.
There is not 1 singular cause to this problem. Rather it has been the perfect storm of problems from raw material shortages to particulates from glass vial shedding into the meds causing a recall to poor manufacturing practices and the FDA mandated shutdowns to fires in warehouses.
But in the end patients are suffering. The negative effects include death because certain antibiotic agents are unavailable (for example amikacin, sulfamethoxazole/trimethoprim, acyclovir).
An earlier post accused hospitals of hoarding. While there is some of that going on (and I have and will continue to order a LITTLE extra to keep our patients alive until we can mitigate a therapeutic interchange) I do believe the hoarding is on the part of the secondary drug suppliers. We call them gray market because while their practices are not illegal (black market) they are certainly unethical and greed driven. I have personally seen some of their price markups surpass 3000%. That is one of the most unacceptable parts of this whole shortage. Why not publish an article about their practices.

[MaggieVV]

As a person living with Stage IV cancer, I, too, was left wondering WHY some cancer drugs are in short supply after the CBS News story last night. According to Reuters on 6/7/11, "many drugs are scarce because there is no incentive for drugmakers to manufacture low-cost generics." So in addition to patients being denied treatment, the cost of care likely goes up. On that note, Medicare cost-cutting measures focus on lowering fees for doctors and hospitals but, as far as I can tell, no one is willing to cut what pharmaceutical companies receive or make sure that generics and older less expensive drugs are available for patients. This is subject is also an elephant in the room in terms of national debt reduction. All of this is prime material for investigative journalism, but do you think maybe the fact that pharmaceutical companies provide so much advertising revenue might make this unlikely?

[Deltau]

Adding to a previous comment on superficial reporting. The shortage story has been appearing periodically invarious outlets - all at the same superficial level of detail. No probing, but always comment on what the FDA should do - no digging up why the drug companies are shorting - no questions about what is the stuff made of and where does that come from. Seems like the shortages and the reporting have a common cause.

[kkmal]

After listening to this segment about Cancer Drug shortages I
was furious that you think the shortages are because hospitals
hord the drugs since I am a Pharmacy Buyer and have to deal with
this everyday I believe the government should start looking into
these 3rd party wholesalers that triple the price of these drugs
the government should regulate this problem it is the patients
that are suffering from all of this!!!!

[joykern]

My sister was just told that she will no longer get Doxil for her ovarian cancer. She was told "here are your other options" toxil put her in the ER. Since Medicare can choose what they will and will not pay for that gives private pay insurance the same option. My sister is private pay. She did not ask for this life sentence but thanks to the government, she has been handed two life sentences. I am furious and I want change. Why should the government get to choose how long she lives and the quality of what life she has left? Maybe the government should hire a few more Kavorcians (sp) and just eliminate the sick, tired, and poor. Oh wait wasn't that what the good ole U.S.A. said back in the day. Bring us your tired, your humble, and your poor.

[littleredtop]

The subject pharmaceutical companies don't care about human life. Their only concerns are increasing profits, reaping big bonuses and jacking up executive salaries. What we're seeing regarding these critical life saving drugs is an artificial shortage which drives the prices way up. It's a simple example of supply and demand. This is what happens in an unregulated environment. I believe these crooks should be held accountable. Perhaps this is something our great leader should be looking into instead of vacationing at taxpayer expense in Chicago.

[joykern]

I agree 100%

[erasmus111]

"Chemotherapy keeps you alive. It's as simple as that," Goodman says.


It keeps you alive for awhile. Then IT kills you.


This woman has been battling ovarian cancer since 1998. She's lucky to be alive. Usually by the time symptoms show up, it's too late.

[greenacresmom]

You call this reporting? There is a shortage of cancer drugs. Dorctors and Patients are worried. Drug companies are sending letters to Dr's telling them not to start patients on certain drugs. WHY???? What is causing the shortage-why did you not bother to dig deep to get that answer-were you afraid you might offend a sponsor? Shameful excuse for journalism.