US physicians are compelled to ration cancer drugs due to a nationwide shortage

Toni Dezomits, a retired law enforcement officer of 55 years, is battling a recurrence of her stage 4 ovarian cancer. She had already undergone multiple cycles of chemotherapy when her doctor broke the bad news.

Ms. Dezomits was told there was a nationwide shortage of the generic chemotherapy drug carboplatin, one of the three medications she was scheduled to receive, the day before her third round of treatment last month. Carboplatin was one of the three treatments that she was scheduled to get.

The native of North Carolina is completing her final three chemotherapy sessions with only two of the recommended drugs after being forced to choose between forgoing the medication or substituting it for one with more severe side effects. She stated that she was left with two suboptimal options and she is concerned as she is not receiving the substance to which her cancer responded favorably [the first time].

According to experts, the United States is experiencing one of the most severe shortages of chemotherapy medications in three decades.

According to Dr. Julie Gralow, the chief medical officer of the American Society of Clinical Oncology, Ms. Dezomits is one of as many as 100,000 patients who may have been affected during the past few months. This week, the US Food and Drug Administration (FDA) reported that over 130 drugs, including 14 cancer treatments, were in limited supply.

Multiple factors, according to experts, have contributed to the shortages, which have severely impacted two first-line therapies, carboplatin and cisplatin, used to treat a variety of malignancies, including head-and-neck, gynecologic, and gastrointestinal cancers.

The most recent shortage was caused by the closure of an Indian plant that supplied cisplatin materials to all U.S. manufacturers. Dr. Gralow stated that this increased demand for a substitute substance, carboplatin.

As a result, some providers have been forced to extend the time between chemotherapy regimens for patients, and some patients have had to travel several hours to different cancer centers to receive treatment.

When her local oncologist was unable to supply her with carboplatin, Ms. Dezomits visited a larger cancer center in Texas where she had previously been treated. However, she was informed that she could not receive the medication because it was being given to patients with greater chances of recovery first. "It's like triage on the battlefield," said Ms. Dezomits, a veteran of the Persian Gulf War, who was a combatant. “This nation ought to be a bit better than that. We should be able to obtain life-saving medications for approximately $9 or $10 per dose.”

According to specialists, the low cost of generic first-line cancer drugs has contributed to recurring chemotherapy drug shortages. Dr. Karen Knudsen, chief executive officer of the American Cancer Society, stated that although the drugs are inexpensive to produce, pharmaceutical companies are not incentivized to do so because they do not generate significant profits.

The drug shortage problem has also exacerbated as US life expectancy has risen, resulting in an increase in the number of cancer patients. This week, the FDA began collaborating with a Chinese manufacturer to import one of the chemotherapy drugs in an effort to alleviate supply chain constraints.