Health
Related: About this forumWhen There Are Chemotherapy Shortages, Rationing Is Up to Doctors
http://www.theatlantic.com/health/archive/2013/10/when-there-are-chemotherapy-shortages-rationing-is-up-to-doctors/280624/A chemist prepares chemotherapy (Eric Gaillard/Reuters)
Recently the American Society of Health Systems Pharmacists (ASHP) announced that there may be another Doxil shortage coming down the pipeline. Doxorubicin (commonly known as Doxil or the Red Devil) is a chemotherapy drug used to treat adults and children suffering from leukemia, lung cancer, sarcoma, and other types of cancer. It is not a particularly nice drug. Side effects include potential heart damage, swelling of the hands and feet, and peeling skin, not to mention the more conventional side effects associated with chemotherapy such as vomiting and hair loss. But while treatment with Doxil may not be a pleasant experience, the drug saves lives. For patients faced with a decision between the spread of malignant tumors and swelling hands the choice seems obvious.
Currently cancer is the second most common cause of death in the United States, after heart disease. There are more than 10,000 cases of childhood cancer reported annually in the U.S., and more than half a million Americans total die from cancer each year. In view of this, one might expect that chemotherapy drugs would be readily available. Regrettably, this is not always the case. While there is more Viagra, Cialis, and Rogaine than any septuagenarian could possibly want or need, we in the U.S. do not consistently produce enough lifesaving chemotherapy drugs to allow our parents, grandparents, or children their best shot at survival. We have the resources to do so, but we opt not to.
This isnt a simple issue. No doubt the pharmaceutical companies who manufacture these essential drugs are aware of the number of cancer patients in this country. One obvious factor in the U.S. is that the Food and Drug Administration (FDA) does not strictly control production and pricing. The FDA is primarily concerned with ensuring that products within its purview are safe and effective. Manufacturing details are left in the hands of the for-profit pharmaceutical industry, which spends millions, if not billions, of dollars developing these drugs and shepherding them into production. While there is certainly an upside to producing drugs this way, problems inevitably arise, including issues of patents, pricing, and projected versus actual demand. Such conditions create fragile and sensitive markets where a single problem can send shockwaves through the entire treatment structure.
Unfortunately, a result of this situation is that drug shortages have become a way of life, and hospitals and clinics are constantly preparing for the day when drugs such as Doxil will run out. Eighty-three percent of oncologists in the U.S. report being affected by the lack of chemotherapy drugs. Where can we get more? How quickly can they be delivered? How much is it going to cost? What happens when there is no more to be had? These are the types of questions that haunt clinicians and pharmacists across the country.
Warpy
(111,115 posts)I started to see shortages and even an absence of drugs in hospitals in the early 00s, some of them common and rather basic to patient care, including anti nausea, antibiotic, and seizure control medications.
Much of it is probably due to offshoring. We need to start making things ourselves again. It's the only way to assure an adequate supply of high quality items from clothing to life saving drugs.
kestrel91316
(51,666 posts)and anti-inflammatories (prednisolone acetate injection, prednisolone tablets) for years at a stretch. We even lost generic amoxicillin suspension, apparently permanently (of course the expensive proprietary version is still available). Makes it very hard to help our patients sometimes.
question everything
(47,421 posts)thus it is generic and the profit margin is very low.
I think that several years ago Senator Amy Klobuchar passed a law, or asked for a procedure where hospitals and clinics alert the FDA of an upcoming shortage, thus allowing the U.S. to import them from Canada. Or other places.
Not sure whether this ever passed.