Cancer drugs are in short supply in United States

Some essential chemotherapy drugs are in short supply for the first time in the United States, according to the November 3 New England Journal of Medicine. Most are generic drugs – vincristine, methotrexate, leucovorin, cytarabine, doxorubicin, bleomycin, and paclitaxel – that physicians have prescribed for years in childhood leukemia and curable cancers.

The shortage has caused serious concerns about safety, cost, and availability of life-saving treatments. In a survey from the Institute for Safe Medication Practices, 25% of clinicians indicated that an error had occurred at their site because of a drug shortage. Many of the errors were attributed to inexperience with alternative products.

The shortage has increased the already escalating cost of cancer care. Brand-name substitutes for generic drugs can add substantially to the cost.

The main cause of the drug shortage is economic. If manufacturers don’t make enough profit, they won’t make generic drugs. If a brand-name drug with a higher profit margin is available, a manufacturer may stop producing its generic equivalent. Contamination and shortages of raw materials likely account for less than 10% of the shortages.

While acknowledging that most cancer centers quadruple-check drugs for accuracy, the authors said “it is only a matter of time” before the death of a patient with cancer is linked to the shortage.