NLM Director's Comments Transcript
Chemotherapy Shortages's Impact: 12/12/2011
URL of this page: http://www.nlm.nih.gov/medlineplus/podcast/transcript121211.html
A shortage of generic chemotherapy drugs in the U.S. endangers patient safety and is a significant barrier to cancer treatment, suggests a candid and perceptive editorial recently published in the New England Journal of Medicine.
The authors explain a recent survey from the Institute of Safe Medication Practices found about 25 percent of participating clinicians reported errors occurred where they practice because of drug shortages. The authors report these errors include: clinical misuse of alternative products (such as using a less effective substitute for an unavailable medication) and an incorrect administration of a substitute drug that can result in an inadvertent overdose.
The authors report more than half of recently surveyed hospitals purchased grey market medications to respond to current chemotherapy drug shortages. Albeit expedient, the authors note grey market drug purchases introduce safety and quality-control issues.
While the authors report they are not aware of a patient death because of chemotherapy drug shortages and substitutions, they write (and we quote):... 'it is only a matter of time' (end of quote).
The authors note the primary causes of chemotherapy shortages are financial. The authors explain if a brand name medication provides a higher profit margin, a manufacturer may stop producing a generic version of a chemotherapy drug.
In addition, the authors explain current drug shortages are a byproduct of disincentives for oncologists (cancer specialists) to use generic medications. The authors contrast the business model of oncologists with some other medical specialties and note a primary source of medical office profits is drug sales to patients. They write (and we quote): 'In recent decades, oncology-drug prices have skyrocketed, and today more than half the revenue of an oncology office may come from chemotherapy sales, which boost oncologists' salaries and support expanding hospital cancer centers' (end of quote).
The authors add the cost to administer some generic chemotherapy drugs is now higher than the reimbursement physicians receive under federal and state medical insurance plans.
The authors acknowledge other causes of chemotherapy drug shortages include: manufacturing problems, contamination, and shortages of raw materials. However, they write (and we quote) 'contamination and shortages of raw materials probably account for less than ten percent of the shortages' (end of quote).
The authors cite some imaginative efforts within medical centers to avoid shortages, including an early warning system when chemotherapy supplies are moderate to low. The authors explain some medical centers now have protocols that prioritize chemotherapy for patients with curable cancers whenever drug supplies dwindle.
To reverse the trend and provide a more predictable supply of generic cancer drugs, the authors find manufacturers need reasonable profits and oncologists need new incentives to use generic medications. The authors write the only good news is (and we quote): 'the drug shortages may catalyze a shift from a mostly market-based system to one that rewards the provision of high-quality cancer care at an affordable cost' (end of quote).
MedlinePlus.gov explains chemotherapy is a drug therapy that kills cancer cells or stops them from multiplying. MedlinePlus.gov explains while chemotherapy can impact healthy cells, these usually recover after treatment ends.
The side effects of chemotherapy treatment are described extensively in the 'related issues' section of MedlinePlus.gov's cancer chemotherapy health topic page. The side effects covered include: nausea and vomiting, infection, pain, fatigue, and hair loss.
MedlinePlus.gov's cancer chemotherapy health topic page also contains sections for women, men, teenagers, and children that provide tailored information about chemotherapy's clinical impact.
MedlinePlus.gov's cancer chemotherapy health topic page additionally contains research summaries, which are available in the 'research' section. Links to the latest pertinent journal research articles are available in the 'journal articles' section.
Information about shortages of chemotherapy and other cancer drugs is available within the 'news' section of MedlinePlus.gov's cancer chemotherapy health topic page.
To find MedlinePlus.gov's cancer chemotherapy health topic page, type 'cancer chemotherapy' that's 'c..h..e..m..o..t..h..e..r..a..p..y'; in the search box on MedlinePlus.gov's home page, then, click on 'cancer chemotherapy (National Library of Medicine).'
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NLM Director's Comments Transcript - Chemotherapy Shortages's Impact: MedlinePlusDr. Mandy Gatesman and Dr. Thomas Smith (the editorial's authors) note current shortages of generic chemotherapy drugs (and we quote): 'have caused serious concerns about safety, cost, and availability of lifesaving treatments' (end of quote). The authors report while the treatment of childhood leukemia is most affected by chemotherapy drug shortages, drug scarcities that impact other cancer patients are widespread.