Published on September 21, 2011

Rogue Valley Medical Center staff and pharmacists staying ahead of cancer drug shortage

The United States is currently experiencing shortages of several drugs used to treat cancer, some of them severe. Patients needing cancer drugs in the Rogue Valley have been able to get the drugs they need. To ensure patients continue to get these life-saving drugs, the pharmacists at Rogue Valley Medical Center have been working closely with the oncologists, or cancer physicians in the area to track and order drugs and keep them stocked.

Close and frequent communication is the key. “We are meeting with pharmacy and doctors on a weekly basis,” said Sue Kilbourne, RN, clinical manager of Oncology at Rogue Valley Medical Center, adding that there are also daily updates with physician offices. “We are working as a community for the patients and we are being as proactive as possible.”

When a physician diagnoses a patient with cancer and prescribes a course of chemotherapy, the physician communicates with the Pharmacy, who tracks down supplies of the drugs needed and orders enough for the entire course of treatment.

“We look at what the patient needs for an entire course of the drug and then stock it for them. I think we are taking the right approach,” Kilbourne said.

If one drug is not available, an equally effective substitute is prescribed by the physician. For some treatments, the oncologist prescribes a combination of chemotherapy drugs instead of a solo agent that may be in short supply. There is not just one drug for each kind of cancer. So if one drug is in short supply, the pharmacist and oncologist work together to determine if stock is available for an alternative.  For some cancers, such as leukemia, there are limited therapy options.  Rogue Valley Medical Center has been able to acquire many shortage drugs directly from the manufacturer to ensure patients are able to receive their entire course.

“Our pharmacists are keeping close tabs on what drugs are available and where,” Kilbourne said.

The drug shortage was caused by several factors. One main cause is the Food and Drug Administration tightening quality controls on drug manufacturers. The good news is increased safety. An estimated 80 percent of the raw materials used in pharmaceuticals come from outside the United States.  Availability problems arise when there are climate and environmental changes,  products are contaminated, and when there are political issues.  The bad news is drug makers have to shut down production while they bring their manufacturing process up to safe standards.

Another major cause of the shortage is drugs becoming available as generic when patents expire. The price of the drug drops so low that several manufacturers may cease production. This can cause a shortage, especially if a manufacturing facility goes offline and there are no others producing the drug.

“But the bottom line is our patients need these drugs for their lives,” Kilbourne said. “We will continue to work proactively to get them, but at some point we hope the drug makers and the government will find an equitable way to keep these drugs avaialble.”  Federal legislation has introducted two bills this year that will ensure that  the FDA is given advanced warning of a shortage by the manufacturers.

For a complete list of all drug shortages, why they are occurring, and when pharmacists expect them to be available again, visit the American Society of Hospital Pharmacists.