Hospitals wrestle with shortage of cancer drugs, becoming a ‘life-threatening issue’

Hospitals are dealing with a shortage of cancer drugs, marking the latest in a series of supply chain challenges for health systems.

The American Cancer Society issued a warning this month that some chemotherapy drugs were in short supply. Some shortages include treatments for triple-negative breast cancer, ovarian cancer and leukemia. The cancer society says some of the drugs that are in short supply don’t have effective alternatives.

“The shortage of certain cancer drugs has become a serious and life-threatening issue for cancer patients across the country,” Karen Knudsen, CEO of the American Cancer Society, said in a statement.

The American Cancer Society is urging the industry “to work with medical practitioners to help identify alternatives where possible to ensure that cancer patients’ treatments are not delayed.”

• Read more: Facing supply chain shortages, hospitals must shift strategies

The Michigan Health & Hospital Association said Wednesday its members are feeling the effects of the shortages which are hampering hospitals, and causing delays in treatments, across the country. Michigan hospitals are seeing shortages of cisplatin and carboplatin, which are used to treat bladder, lung, ovarian and testicular cancers.

Hospitals are working to manage their supplies and in some cases, adjusting chemotherapy treatments for some patients. And health systems are searching for alternative sources of drugs that are in short supplies.

“Drug shortages severely hamper a hospital’s ability to provide patients with the best treatment, while forcing hospitals to implement strategies that may increase the cost of care and sometimes do not offer the same effectiveness in treatment,” Brian Peters, CEO of the Michigan Health & Hospital Association, said in a statement.

Reserve and ration

Chemotherapy drugs are among the five biggest drug shortages in the country through March 31, according to data compiled by the University of Utah Drug Information Service.

Amanda Fader, a professor at the Johns Hopkins School of Medicine and a president-elect of the Society of Gynecologic Oncology, told The New York Times that the shortage of chemotherapy drugs represents “a public health emergency, because of the breadth of the individuals it affects and the number of chemotherapy agents that are in shortage right now.”

Both The New York Times and NBC News have reported on disturbing situations where patients can’t obtain cancer drugs they need for treatment.

In light of the shortages of carboplatin and cisplatin, the Society of Gynecologic Oncology has recommended providers should reserve supplies for patients who will get the most benefit and to ration dosing when possible. The organization also suggested lengthening the time period between treatment cycles when it’s clinically acceptable.

Critics are noting that some of the medications that are in short supply are generic drugs. Michael Ganio, the senior director of pharmacy practice at the American Society of Health-System Pharmacists, told NBC News that manufacturers aren’t investing enough in generics because they are less profitable.

“There’s little incentive to invest in generic manufacturing, oftentimes, especially for these much older drugs — the margins aren’t very big,” Ganio said.

More data needed on supplies

Tom Cotter is the executive director of Healthcare Ready, a non-profit organization that helps health systems prepare for and respond to emergencies. In an interview with Chief Healthcare Executive® in March, Cotter said there needs to be greater visibility in the supply chain.

“I think people think there's more visibility and transparency than there actually is in the supply chain, especially in the healthcare sector,” Cotter said.

“There's a lot of reasons why businesses want to protect that data. And a lot of them are legitimate," he said. "There's antitrust and competitive reasons. But there are a lot of business cases for ensuring there are minimized supply chain disruptions and greater supply chain resiliency.”

Cotter says the industry needs to create more resiliency in the supply chain, and he stressed the need for better data. He called for a greater understanding of the key actors in the supply chain, including those who hold significant market share for certain products.

“The supply chain at the end of the day is more of a supply web,” Cotter said. “And there's a lot of interdependencies. There's a lot of different factors and stakeholders.”

Hospitals and health systems have been weathering some shortages of drugs for years, and supply chain disruptions have been exacerbated in the COVID-19 pandemic. A U.S. Senate report released in March found a nearly 30% increase in drug shortages from 2021 to 2022.

Earlier this year, shortages of drugs such as albuterol, which is used to help millions with asthma, and children’s ibuprofen commanded national attention.

Hospitals and health systems had to postpone exams in the spring and summer of 2022 due to a shortage of contrast dye, which is used in imaging to enable clinicians to see tissues, blood vessels and organs more clearly.

The White House has assembled a team to tackle the persistent shortages of prescription drugs, Bloomberg reported last week.

Data Book podcast: Tom Cotter of Healthcare Ready talks with Chief Healthcare Executive about the need for more data in the supply chain and how the industry should prepare for disasters and pandemics.