How drug shortages could affect the future of cancer care
A recent survey shows oncologists and patients are facing a dilemma in cancer treatment. Drug shortages, combined with high cost of chemotherapy, were found in an independent analysis to have dire consequences for 73 percent of cancer patients who can't afford co-payments. The result is that cancer patients are dying sooner and some oncologists are sensing a bleak professional future.
The survey, conducted by the National Analysts Worldwide, confirms "...some of our worst fears," says Susan Schwartz McDonald, President and CEO of National Analysts Worldwide and a lead researcher on the survey. "At a time when important advances promise new hope in many forms of cancer, chronic drug shortages and reduced access to care threaten to undermine our ability to combat disease."
Dr. David Loeb, a pediatric oncologist, recently published concerns about cancer drug shortages. According to Loeb, reasons oncology drugs are in short supply are complex.
He explains, “Briefly, the problem can be traced, in part, to a rule by The Centers for Medicare and Medicaid Services (CMS) called the ASP + 6 Rule. This rule limits what a private oncologist can charge for a chemotherapy drug to the Average Sale Price plus 6%.”
Older cancer drugs are available in generic, and remain inexpensive.
“A vial of carboplatin once sold for $125, but recently the cost has fallen to $3.50. Add 6% to that, and you certainly don't recoup the cost of administering the drug in your office”, Loeb writes.
Consequently, there is no incentive for drug companies to manufacture generic – and less expensive – cancer drugs, which would help underinsured and uninsured cancer patients. But even if they did, there isn’t any financial incentive for oncologists to use the drugs.
Non-generic cancer drugs are also in short supply because fewer plants manufacture the chemotherapy agents.
Loeb says “There is currently a nationwide shortage of Doxil (liposomal doxorubicin), which is not a generic.” The manufacturing plant was shut down due to quality control issues. As a result research is affected. Oncologists are forced to use drugs they’re not familiar with, which can lead to mistakes that also have dire consequences for cancer patients.