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Thursday
Jun232011

Chemo Drug Shortage Puts Cancer Patients at Risk

Jupiterimages/Stockbyte/Thinkstock(NEW YORK) -- A shortage of Taxol, an intravenous chemotherapy workhorse for ovarian, breast, lung, and colon cancers, demonstrates once again how vulnerable U.S. hospitals and clinics are to an increasingly unreliable pharmaceutical supply chain. The shortfalls continue to leave patients at risk.

Paclitaxel, the generic version of Taxol, joins 196 other drugs on a shortage list compiled by the American Society of Health-System Pharmacists in Bethesda, Md.

Although no one has been able to quantify the number of lives jeopardized by the shortages, the lengthy list underscores that the country is in the midst of a "public health crisis of drugs overall," said Cynthia Reilly, director of the group's practice development division.

Paclitaxel made the list May 13, with a June 16 update. Additions in the last month include such chemotherapy mainstays as doxorubicin, daunorubicin, carboplatin, vincristine and cytarabine; the quick-acting anesthetic propofol; the injectable painkiller Fentanyl and injectable forms of several powerful antibiotics: clindamycin, ciprofloxacin, and gentamicin.

For more than a year, "we've been having a crescendoing of drugs that are in short supply. This has been going on for some time now," said Dr. Michael P. Link, a Stanford University pediatric oncologist who serves as president of the American Society of Clinical Oncology. He called the paclitaxel crunch "another add-on."

In response to an ABC News request for comment about their paclitaxel supplies, a dozen major U.S. hospitals and medical centers said they hadn't experienced a shortage. Among them: the Fred Hutchinson Cancer Research Center in Seattle, Duke University in Durham, N.C., the University of Rochester Medical Center in New York, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Maimonides Cancer Center in Brooklyn, N.Y., Georgetown University's Lombardi Comprehensive Cancer Center in Washington, D.C., and Indiana University-Purdue University in Indianapolis.

Still, some of the largest and most renowned U.S. medical centers reported being short of paclitaxel, along with other important drugs. "In my 25 years as a cancer MD, I have never, never seen this," said Dr. Jay Brooks, chairman of hematology-oncology at the Ochsner Clinic Foundation and Hospital in New Orleans, where 800 doctors and 20 oncologists "work together to shift drugs where needed for patients."

Burgeoning drug shortages in the past decade, particularly among injectable generics, suggest that the U.S. pharmaceutical business is operating under "an economic model that apparently is no longer tenable," said Dr. Neal J. Meropol, chief of hematology and oncology at University Hospitals Case Medical Center in Cleveland.

He suggested the system might need to change if producers cannot make adequate profits on low-cost generic drugs "to make it worthwhile to continue producing them with a high degree of reliability."

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