KING COUNTY, Wash. (KOMO) — A combination of drugs developed to treat leukemia, lymphoma, breast, ovarian, uterine, colon, gastrointestinal cancers, and more is now in very short supply.
“It’s pretty crazy! I’ve been practicing for 27 years and never experienced this!” said Missy Sauvage, a clinical pharmacist who oversees a number of oncology clinics in Pierce County.
She told KOMO News the drugs in short supply are Carboplatin (ovarian cancer), Cisplatin (testicular, ovarian, bladder, head and neck, lung and cervical cancer), Methotrexate (acute lymphoblastic leukemia, non-Hodgkin's lymphoma), Fluorouracil (basal cell carcinoma) and Oxaliplatin (colon or rectum cancer).
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“In some cases, there may not be very many alternatives,” said Dr. Bill Kriegsman, the chief medical officer at Capital Medical Center in Olympia. “What we’re trying to do is get the patient who can benefit most from the medication.”
Dr. Kriegsman is part of the Incident Command Team at MultiCare, strategizing with the entire state, figuring out where available drugs should go, how they can stretch out doses, and which patients should get drugs that are in such short supply.
When asked, Dr. Kriegsman told KOMO News he hadn’t heard of anyone dying.
“There’s enormous emotional stress on the patient and what we hope is that they have a good relationship with their physicians to be able to work through these different options,” said Dr. Kriegsman.
One of the drugs, Carboplatin, is manufactured by five different companies. Three of those companies, Hospira, a Pfizer company, AuroMedics Pharma and Fresenius Kabi USA, each cite an increase in demand as the reason for the shortage.
AuroMedics Pharma first reported its shortage of carboplatin in April. Fresenius Kabi USA reported a backorder situation on May 17, anticipating its next release to be sometime in June.
When KOMO News reached out to the Fred Hutchinson Cancer Center, they provided a statement that also included the importance of that physician-patient relationship.
That statement also included the following:
We are, however, closely monitoring the situation and proactively preparing to ensure ongoing treatment for our patients.
“I have to give a shout-out to the team that I work with. Procuring a drug is not easy, and they’re spending hours every day on the phone with manufacturers and distribution centers trying to figure out where can we get this. We’re doing a pretty good job at this,” said Sauvage.
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Hospira (Pfizer) told the Food and Drug Administration (FDA) it expects to make deliveries throughout the summer, with full recovery sometime in December. In a letter to its customers, the company wrote:
"Pfizer Hospital is committed to providing timely supply information so that you can plan for patient care. Due to increased demand arising from competitive shortages, we want to make you aware that multiple presentations of Carboplatin Injection, Docetaxel Injection, USP and Methotrexate Injection, USP vials are experiencing a temporary limited supply and intermittent stockout situation.
"Pfizer has been working diligently and increasing output above our historical volumes amidst these competitive shortages, but market demand continues to exceed Pfizer’s production capacity."
Teva Pharmaceuticals, which gives no reason for the shortage, told the FDA supply will remain limited, with recovery not expected until the end of the year.
Accord Healthcare, which also failed to list a reason for the shortage of Carboplatin, reported to the FDA it’s allocating its current inventory until it can return to manufacturing. But there’s no reason given for the current lack of manufacturing.
The FDA said its power is limited during these types of shortages.
The agency, on its website, states it cannot require a pharmaceutical company to manufacture drugs, even if it’s medically necessary. It can, however, expedite reviews for production, extend expiration dates if that’s safe and turn to importing drugs from out of the U.S. if those drugs meet its standards.