Cancer drug shortage: Answers to common questions

As the cancer drug shortage persists, we continue to receive questions from patients at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. While drug shortages are challenging, staff here will always find an appropriate way to treat our patients.

Here are answers to some of the most common questions about these drug shortages, but if you have any questions about your treatment or specific drugs, you should always ask your provider or pharmacist.

Which cancer drugs are in short supply and which cancers do they treat?

There are 100-200 drugs in national shortage at any given time. However, the current number of drug shortages is the highest it’s been in the past decade.

Unfortunately, several generic cancer drugs are in critical shortages, including cisplatin, carboplatin and methotrexate. These agents are used in a number of cancer treatments for several cancer types.

Older generic injectable drugs are at the highest risk of shortages, but any drug may eventually end up in shortage for a variety of reasons.

Why is there a cancer drug shortage? How long will it last?

The current cancer drug shortages are caused by manufacturing issues. A major manufacturer of cisplatin and carboplatin was banned from importing products by the U.S. Food and Drug Administration due to issues with quality testing and cleanliness, which could cause the products to be nonsterile. Pharmaceutical manufacturers rarely share specific timelines for shortage recovery, so we don’t know when to expect an improvement. These current shortages will likely last several more months, but new shortages could happen at any time.

How do cancer drug shortages affect patients?

The OSUCCC – James is fortunate to source enough of these drugs to maintain care for all our patients. To be proactive, we’re making some changes in how the pharmacy prepares the drugs to reduce waste and stretch the available supply.

Providers are considering when to use alternative treatments, when to make adjustments to doses and how long to continue therapies.

When safe and equally effective alternative cancer treatments exist for patients’ cancer types, those may be used avoid the shortage drugs entirely.

As the shortages continue without resolution, one concern is that there may be a need to further switch patients to other regimens or extend time between infusions.

What is the OSUCCC – James doing to manage cancer drug shortages?

The Department of Pharmacy at the OSUCCC – James maintains a Drug Shortage Committee to review current shortages and develop plans to maintain usual care. The committee is made up of different health care providers, including pharmacists representing different teams or areas. This group authorizes changes and implements plans to address each shortage, reviewing any new updates at least weekly and adjusting as needed. This group also helps communicate the shortage situation to staff and provides directions on any changes, if needed.

The OSUCCC – James has several pharmacy purchasers dedicated to cancer drugs, who are able to proactively check available distributors for potential shortage issues before they are declared in national shortage by the FDA. For those drugs that are at risk of shortages and are critical for care, we attempt to keep at least a three-month supply in inventory.

The committee also is engaged with providers and division chairs for all impacted cancer types to help develop current plans that allow us to stretch our available supplies and maintain drugs for patients who absolutely need them.

How do health care systems work together to help patients facing shortages?

Smaller treatment centers and neighboring community hospitals typically are impacted more dramatically by shortages. If we have enough surplus, we’ll loan inventory to other sites to cover patients on their immediate schedules. Our cancer center may also take new patient referrals if those patients are unable to receive infusions at their usual sites. Our Department of Pharmacy works closely with other pharmacy staff at hospitals across Ohio and nationally to share ideas and solutions to navigate the most critical shortages.