A shortage of cancer drugs is forcing doctors to confront the reality that some patients could die needlessly.
“Lives will be shortened,” Dr. Patrick Timmins III, a gynecologic oncologist at Women’s Cancer Care Associates in Albany, New York, told the Atlantic.
“A lot of people are going to be hurt,” he added. “I’ve been doing this forever, and this is absolute lunacy.”
Timmins is just one of thousands of doctors worldwide who are struggling with an acute shortage of drugs.
Some of these are nonprescription drugs, like cold and flu medicines. But life-saving drugs for cancer patients are also not available.
The drugs carboplatin and cisplatin, for example, are the preferred treatments for a wide range of cancers, including ovarian, breast, lung and testicular cancers.
But 93% of cancer centers are experiencing shortages of carboplatin and 70% are short on cisplatin, according to a National Comprehensive Cancer Network survey.
The drug shortage is so extreme that it’s a national security threat, according to a recent Senate Homeland Security and Governmental Affairs Committee report.
“These shortages [are] causing delays in treatment, increasing the risk of medication errors, and requiring the use of less-effective alternative treatments,” the report said.
The causes of the drug shortage are varied, but most experts point to the glaring gaps in the drug supply chain as a primary cause.
One foreign manufacturer, Indian drugmaker Intas Pharmaceuticals, was cited during a Food and Drug Administration inspection in November 2022 for numerous safety and quality-control problems.
After their manufacturing facility closed, the world was suddenly caught in a supply chain nightmare, as Intas was a primary source of chemotherapy drugs.
As doctors scramble to find desperately needed cisplatin, the FDA has allowed a manufacturer in China to import their cisplatin, even though it “is marketed and manufactured in China and is not FDA-approved.”
The root of the problem, experts claim, involves the economics of drug manufacturing. Once a drug’s patent expires, it can be sold as a generic at a much lower cost.
According to the FDA, “91% of all prescriptions in the United States are filled as generic drugs, with more than 32,000 generic drugs approved by the FDA to date.”
But that lower cost makes generic drugs less attractive to manufacturers, so there are fewer drugmakers willing to invest in making the drug. Even offshore manufacturers are forced to cut corners when making the drugs.
“We have a market that’s totally just focused on price” instead of safety or availability,” Dr. Kevin Schulman, a professor of medicine and business at Stanford University, told NPR.
“We save hundreds of billions of dollars a year using generic drugs rather than brand-name drugs, but we only save that money if the drugs are available,” he added.
About 130 generic drugs are now in dangerously short supply — and that list keeps growing, says the Association for Affordable Medicines, a generic drug industry group.
The crisis, in addition to affecting medical staff already burned out after years of COVID-19 stress, is wreaking havoc on a very personal level.
Robert Landfair, 76, was prescribed Pluvicto to treat his stage 4 prostate cancer.
“I definitely need that drug,” Landfair told NBC News.
But Pluvicto manufacturer Novartis has supply problems, leaving Landfair on a monthslong waiting list for the medication.
“We’re kind of handcuffed here as oncologists,” said Landfair’s doctor, Alan Tan of Rush University Medical Center in Chicago, which has shortages of both Pluvicto and cisplatin.
If patients don’t get the drugs they need, Tan added, some of them are “going to die.”