‘Never did I imagine that I would have to ration chemotherapy’

Nationwide shortages of two dozen chemotherapy drugs are leading to rationing and delays in treatment for cancer patients, local and national authorities say.

“The most critical drugs that are being used to cure cancer, potentially, are just in short supply,” said Dr. Rupesh Parikh, an oncologist at Comprehensive Cancer Centers of Nevada.

There are shortages of 23 chemotherapy drugs used to treat a wide range of cancers, according to data from the University of Utah Drug Information Service. Most of these are inexpensive generic drugs used for decades that serve as “the backbone of so many chemotherapy regimens,” said associate chief pharmacy officer Erin Fox, whose team at the university tracks drug shortages.

The shortage in chemotherapy drugs is the worst it has been since 2011, she said. Overall drug shortages are the worst since 2014 for reasons that include curtailment of manufacturing and increased demand.

Parikh said the chemotherapy drug shortage, which has ramped up over the past 12 months, is now at critical mass.

“Never in my entire life did I imagine that I would have to ration chemotherapy to some of my patients, and that’s what’s happening,” he said. “It’s sometimes causing delay of care. Sometimes you have to ration these medicines to patients who need it most, which in America is unheard of.”

Some of these drugs don’t have substitutes and when they do, the substitutes may also be in short supply, he said.

One such drug is cisplatin, which Fox said is used to treat a range of cancers, from testicular cancer to head and neck cancer to cervical cancer. Carboplatin, a substitute for cisplatin, also is in short supply.

These drugs are used as part of many chemotherapy regimens, meaning their shortage “could potentially affect a large number of people,” Fox said.

This particular shortage stems from problems with the factory in India that manufactured 50% of the U.S. supply of cisplatin and 20% of the supply of carboplatin. The plant also made 50% of the supply in the U.S. of methotrexate, another common cancer drug.

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