Shortages of a handful of cancer drugs are causing concern as drug companies delay resupply dates and physicians worry about providing adequate care for their patients.
Ongoing shortages include:
Bacillus Calmette-Guerin is a bladder cancer drug that its only maker, Merck, has had on allocation for years. There is no substitute for the therapy, the American Society of Health-System Pharmacists said in an April 18 post.
Carboplatin, an ovarian cancer drug, was in shortage from 2015 to 2018 after some discontinuations. It fell into another shortage in 2023, and as of June 5, there are 15 solutions back ordered. Predicted release dates are between June and September, the ASHP said.
Cisplatin is a medication used for bladder cancer, squamous cell head and neck cancer, cervical cancer, lung cancer, osteosarcoma, esophageal cancer, adrenal cortex carcinoma, breast cancer, endometrial cancer and liver cancer. Drugmakers have delayed resupply dates at least four times, and some release dates are slated for June.
Dacarbazine, a skin cancer medication, has Fresenius Kabi reporting enough supply, Hikma Pharmaceuticals with one back ordered solution until early fall and Teva Pharmaceuticals with two unavailable solutions without a release date, the ASHP said May 23.
Docetaxel injections are used for breast cancer, non-small cell lung cancer, prostate cancer, gastric adenocarcinoma, and head and neck cancer. As of May 18, 34 solutions are in shortage and 11 are available, according to the ASHP. Four drugmakers said they expect more supply this summer, one forecasted October and seven said they could not estimate a date.
Fluorouracil, commonly known as 5FU, is a therapy usually paired with other oncology treatments that has no available presentations. As of May 31, Fresenius Kabi said it expects five solutions to become available in June, and Sagent Pharmaceuticals predicted one solution to return in June and another in August.
Methotrexate is a treatment for acute lymphoblastic leukemia, breast cancer, lung cancer, and certain types of head and neck cancer. It has been in wavering supply for about a year and there are no available solutions, according to a May 26 ASHP post.
Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is a brand-name prostate cancer drug made by Novartis. It went into shortage in March and the drugmaker said it expects supply to return to normal levels by the end of 2023.
Here are four updates:
1. The FDA allowed China-based drugmaker Qilu Pharmaceutical to import four lots of cisplatin 50 milligram/50 milliliter injections, and the agency's commissioner noted there might be a similar allowance for imported carboplatin.
2. William Dahut, MD, chief medical officer of the American Cancer Society, told The New York Times that "if these drugs are not available, people are going to get inferior care. That's the bottom line. These aren't third- or fourth-line drugs where there are multiple other agents around. These are used up front for people you are trying to cure."
3. Amid the shortage, hospitals are scraping vials for enough therapy. Tallahassee (Fla.) Memorial Hospital workers are using emergency supplies to provide care for their 80 cancer patients, and a professor at Baltimore-based Johns Hopkins School of Medicine told ABC affiliate WJLA pharmacists are using "every drop of chemotherapy."
4. Some oncologists are rationing medications and delaying care because of the dearth.