Jun 20, 2023 04:40 PM
https://www.statnews.com/2023/06/19/cisp...-shortage/
EXCERPTS: Cancer patients, like those I treat in San Diego and thousands more across the country, are facing an alarming shortage of critical chemotherapy drugs, forcing oncologists to ration cancer treatment doses for patients with curable diseases.
That’s right: If you have cancer right now in the United States, the treatment you need might not be obtainable.
Specifically, oncologists have short supplies of platinum-based generic drugs called cisplatin and carboplatin used to treat lung, breast, bladder, ovarian, endometrial, and head and neck cancers. Alternative, brand-name versions of those drugs are not manufactured anymore and aren’t available. The platinum shortage has been severe for about a month, but it has been brewing for several months. We have been battling one shortage after another on and off for the past few years, and it’s getting worse and worse.
Every week at my practice, my colleagues and I are now forced to compile a list of how much cisplatin and carboplatin we have compared to how much we need. [...] Sadly, this isn’t the first time cancer patients have dealt with drug shortages, but now the problem is worse, prevalent, and spreading.
[,,,] Yet it doesn’t seem like there’s much sense of urgency to fix the problem.
The economics of manufacturing generic drugs are broken. Most drugs in short supply are older generics that are off-patent and complicated to manufacture. Combine those attributes with extremely thin profit margins, and companies are disincentivized from manufacturing them. The result is that one or two companies are the only manufacturers of certain cancer drugs, with an insufficient ability in their supply chain to accommodate any complication. So, when a facility shuts down, the generic drug supply chain gears seize.
The causes of the current wave of shortages are systemic with no silver-bullet solution to address them. The drug price negotiation provisions included in the Inflation Reduction Act [Biden, 2022] and the outsized negotiating power of insurance company-run middlemen, known as pharmacy benefit managers, are likely to compound drug shortages. So fixing today’s cancer drug short requires a direct response from both the private and public sectors... (MORE - missing details)
EXCERPTS: Cancer patients, like those I treat in San Diego and thousands more across the country, are facing an alarming shortage of critical chemotherapy drugs, forcing oncologists to ration cancer treatment doses for patients with curable diseases.
That’s right: If you have cancer right now in the United States, the treatment you need might not be obtainable.
Specifically, oncologists have short supplies of platinum-based generic drugs called cisplatin and carboplatin used to treat lung, breast, bladder, ovarian, endometrial, and head and neck cancers. Alternative, brand-name versions of those drugs are not manufactured anymore and aren’t available. The platinum shortage has been severe for about a month, but it has been brewing for several months. We have been battling one shortage after another on and off for the past few years, and it’s getting worse and worse.
Every week at my practice, my colleagues and I are now forced to compile a list of how much cisplatin and carboplatin we have compared to how much we need. [...] Sadly, this isn’t the first time cancer patients have dealt with drug shortages, but now the problem is worse, prevalent, and spreading.
[,,,] Yet it doesn’t seem like there’s much sense of urgency to fix the problem.
The economics of manufacturing generic drugs are broken. Most drugs in short supply are older generics that are off-patent and complicated to manufacture. Combine those attributes with extremely thin profit margins, and companies are disincentivized from manufacturing them. The result is that one or two companies are the only manufacturers of certain cancer drugs, with an insufficient ability in their supply chain to accommodate any complication. So, when a facility shuts down, the generic drug supply chain gears seize.
The causes of the current wave of shortages are systemic with no silver-bullet solution to address them. The drug price negotiation provisions included in the Inflation Reduction Act [Biden, 2022] and the outsized negotiating power of insurance company-run middlemen, known as pharmacy benefit managers, are likely to compound drug shortages. So fixing today’s cancer drug short requires a direct response from both the private and public sectors... (MORE - missing details)