Monday, June 26, 2023

Because of shortage of $15 drug, doctors being forced to choose which cancer patients will live

"The shortage of a $15 cancer drug is upending treatment," says a story by Christina Jewitt in today's editions of The New York Times.

The result, the story indicates, is that physicians are being forced "to put a priority on the patients who have the best chance of survival." 

Oncologists fear "that the alternatives to two crucial chemotherapy drugs [cisplatin and carboplatin] are far less effective in treating certain cancers, and are sometimes more toxic," the article continues. 

Patients with ovarian, testicular, breast, lung, and head and neck cancers are particularly at risk.

The two main drugs, the story says, "are deployed in frontline medicines in cocktails used to shrink or eliminate tumors [but] more than a dozen cancer drugs are also officially in short supply, as well as hundreds of other medications, including antibiotics and sterile injectable fluids." 

It is likely that the shortages will continue for some time, probably "through the fall or later" — despite the easing on restrictions on imported drugs from China. 

Part of the reason for the shortages was the closing of a plant that was a main producer of the more popular drugs.

Dr. Angeles Alvarez Secord
The Times piece quotes Dr. Angeles Alvarez Secord, a professor at the Duke University School of Medicine and president of the Society of  Gynecologic Oncology, as saying, "We're in a situation where patients are being left behind."

Although cisplatin and cargoplatin are inexpensive ($15 and $23 per vial), few companies make them because their manufacture "requires a reliable supply of platinum…as well as a sterile plant and special controls to protect workers from the drugs' toxic effects."

Patients with ovarian cancer face "the worst outlook," according to Dr. Ravi Rao, an oncologist at the cCare Center in Fresno, California, where the absence of the drugs means a patient with an extensive case "has odds of survival that fall to the single digits from about 30 percent."

The shortage "will lead to people dying," he added. "There is no way around it. You cannot remove these lifesaving drugs and not have bad outcomes." 

More information on crucial drugs can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

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