Oncology Drug shortage

  1. 0 I want your take on the recent oncology drug shortage we are experiencing now. Drugs like cytarabine, leucovorin, thiotepa, etoposide, bleomycin, doxorubicin, and cisplatin. During our last GI tumor board meeting, I heard about clinics in the midwest complaining about shortage of 5FU. Im concern about inadequate substitutions, inadequate alternatives and rationing. Its hard for me to explain to a patient that I can not give them X drug because they are not enrolled in a clinical trial or that they are not being treated adjuvantly. It distresses the patients and it worries me.

    Whats your take on this situation?
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  3. Visit  plum94 profile page

    About plum94

    plum94 has '15' year(s) of experience. 44 Years Old; Joined Dec '04; Posts: 34; Likes: 1.

    20 Comments so far...

  4. Visit  tewdles profile page
    0
    I just got a partial does of my chemo yesterday because of the shortage. The clinic informed me that they cannot guarantee that they will have all of the agents for my FOLFOX at my next cycle, but that they would do their best.

    I wonder how this affects my survival prognosis which is already 15-19% at 5 years?
  5. Visit  DeLanaHarvickWannabe profile page
    0
    Quote from tewdles
    I just got a partial does of my chemo yesterday because of the shortage. The clinic informed me that they cannot guarantee that they will have all of the agents for my FOLFOX at my next cycle, but that they would do their best.

    I wonder how this affects my survival prognosis which is already 15-19% at 5 years?
    I am so sorry to hear this. I have no words to offer you, other than I will be praying for you and thinking of you as you fight this fight.

    I wasn't aware that there was a shortage of oncology drugs, but there's a shortage of every other kind, so I guess it's not shocking. Does anyone know the reason?
  6. Visit  tewdles profile page
    0
    I am not certain...I think it is a manufacturing issue. I have to admit that I have not investigated very thoroughly as it is so close to home for me that I do not need one more thing to be anxious about.
  7. Visit  scma profile page
    0
    Here on the east coast we have also experienced shortages in several medications, some of them for several years. some companies gave us a reason of problems at the plant, then because one plant had problems the other companies could not keep up with the manufacturing demands. We just started receiving Leucovorin and are still have of Doxil. It is truly a said state of affairs.
  8. Visit  DeLanaHarvickWannabe profile page
    1
    Quote from scma
    Here on the east coast we have also experienced shortages in several medications, some of them for several years. some companies gave us a reason of problems at the plant, then because one plant had problems the other companies could not keep up with the manufacturing demands. We just started receiving Leucovorin and are still have of Doxil. It is truly a said state of affairs.
    I am on the east coast as well and have experienced shortages with IV preparations of Lopressor, Bactrim and Morphine.

    Those all directly affect my practice as a MedSurg nurse. We don't administer IV chemo on my floor (and very rarely administer PO chemo) so I wasn't aware of issues surrounding these drugs.

    It breaks my heart, though. The Bactrim upset me as well because of all of the AIDS patients I've cared for who NEED IV Bactrim and there is no real substitute.

    I know chemo drugs have much more specific regimens than that and the thought of oncology patients finding that drug that works best, then being told treatment may be complicated by a DRUG SHORTAGE? Very upsetting.
    tewdles likes this.
  9. Visit  JustEnuff2BDangerous profile page
    0
    I had a 5-day regimen of inpatient IV chemotherapy delayed by a day because there is apparently a shortage of Taxol as well (patient's Day 1 was Taxol only; Days 2-5 were Ifex and Cisplatin). So it's not only potentially affecting outcomes, it's lengthening hospital stays as well.
  10. Visit  annister profile page
    1
    Call me crazy, but I think it's all a matter of money.
    We have had issues (on and off) getting IV:
    B12
    Magnesium
    Decadron
    Leucovorin
    Cisplatin
    5-FU
    and most recently, Taxol (probably THE most frequently given drug where I work)

    It's not only an unfortunate obstacle in successfully treating our patients, but a safety concern as the original orders are constantly changing to accommodate these shortages and other drugs are being substituted.

    I wish I knew a solution to the issue, but I don't.
    tewdles likes this.
  11. Visit  FroggyRN-OCN profile page
    0
    What I have been hearing as far as shortage of 5FU, is that the quality that the United States is receiving from other countries is poor quality or contaminated. So very frustrating!
  12. Visit  tewdles profile page
    0
    Quote from FroggyRN05
    What I have been hearing as far as shortage of 5FU, is that the quality that the United States is receiving from other countries is poor quality or contaminated. So very frustrating!
    I am pretty sure that I do not want poor quality or contaminated 5FU. I will discover on Wednesday if my course this week will be affected in any way. Sigh...one more thing...
  13. Visit  anc33 profile page
    2
    Quote from FroggyRN05
    What I have been hearing as far as shortage of 5FU, is that the quality that the United States is receiving from other countries is poor quality or contaminated. So very frustrating!
    Of the three companies that the supplies the US with 5-FU, only one is foreign. That company, Teva, has cited "manufacturing delays" as the reason for their shortage. Increased demand is the official reason for the other two. The FDA does not routinely allow for importation of drug that was produced for other countries (not even EU countries) because it may not be up to spec.

    The vast majority of drugs listed as being in short supply by the FDA are generics. In most cases, manufacturers do not produce these drugs year round but in batches. They estimate the amount that is needed based and prior years and produce only that amount. These drugs do not make them a profit so there is no impetus for them to produce more. When the demand suddenly increases it is difficult for them to switch gears and accomodate the change. At least with 5-FU we have a viable alternative.
    annister and tewdles like this.
  14. Visit  OCNRN63 profile page
    4
    Quote from anc33
    Of the three companies that the supplies the US with 5-FU, only one is foreign. That company, Teva, has cited "manufacturing delays" as the reason for their shortage. Increased demand is the official reason for the other two. The FDA does not routinely allow for importation of drug that was produced for other countries (not even EU countries) because it may not be up to spec.

    The vast majority of drugs listed as being in short supply by the FDA are generics. In most cases, manufacturers do not produce these drugs year round but in batches. They estimate the amount that is needed based and prior years and produce only that amount. These drugs do not make them a profit so there is no impetus for them to produce more. When the demand suddenly increases it is difficult for them to switch gears and accomodate the change. At least with 5-FU we have a viable alternative.
    How about the impetus of helping people live? I guess that doesn't do much for the shareholders, though, does it?
    eagle78, annister, bluebird123, and 1 other like this.
  15. Visit  tewdles profile page
    0
    I thought you might find this interesting http://www.cancer.org/Cancer/news/Ne...s-and-patients

    So do we have a shortage of drugs like 5FU and leucovorin because the manufacturers want to transition us to newer and more profitable drugs? What? How about let the MDs and patients decide which drug regime they use rather than have it force fed them by big pharma.
    Last edit by tewdles on Sep 14, '11


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