The United States has a severe shortage of more than two hundred drugs, including albuterol for asthma, sodium chloride – an intravenous saline, and the platinum-based generic drugs cisplatin and carboplatin for cancer.
“[My friend] started on the chemotherapy treatment with [a] carboplatin dose, and was told when she got there that they had run out,” said Glenna DeJong in Saugatuck, Michigan, who’s calling senators for her friend who's living with ovarian cancer.
In Nebraska, Alison Rash is treated with a drug called fluorouracil (5-FU), also a generic, for breast cancer.
“When I showed up at chemo a couple of weeks ago, my oncologist said ‘Can we move your day for chemo so that other patients can also use the same vial?’” Rash said.
Low-cost generic drugs have been in short supply for years in every state. But now, it’s reached a crisis point because “these drugs are very hard to make; there’s not much margin, not much profit in making,” said Robert Louie, vice president at RemedyOne, a consumer health care cost savings company.
He said American pharmaceutical companies got out of generic chemo manufacturing with supply coming in mostly from a handful of manufacturers overseas, including Intas Pharmaceuticals in India, which stopped imports to the U.S. following quality concerns.
At Eastern Connecticut Hematology and Oncology Associates [ECHO] in Norwich, oncologist Dr. Dinesh Kapur, said chemo infusions at clinics, like his, cost about three times less than in hospitals — he’s trying to not send patients there, even though other oncologists have had to.
Kapur holds a vial that’s just arrived from a supplier in China. The U.S. Food and Drug Administration is working with China-based Qilu Pharmaceutical Co. to allow temporary imports of cancer drugs.
“So a medicine that was costing $30, the suppliers are now charging $279,” he said.
But Medicare still reimburses his practice at the old rate. Kapur said he’s willing to take the cut for as long as he can get supply.
The good news at Yale Smilow Cancer Hospital, said Dr. Roy Herbst, chief of medical oncology at Smilow is that Yale is well stocked at the moment.
Herbst said that doesn’t mean that the supply shortage is any less of a concern in the medium to long term.
“We actually will reserve these drugs for the tumors where they are more critical,” he said. “So if someone has a cancer where we can substitute one of these short supply drugs, cisplatin for example, with something else, we will. When possible, we're selecting alternative regimens.”
Dr. Peter Yu, physician-in-chief of Hartford HealthCare Cancer Institute, also said the group is stocked as of now, but a committee is looking into how doctors can stretch out treatments or give “a slightly lower dose where we have evidence that [it] doesn't harm the patient.”
