Wednesday, February 15, 2012

This is not a drill!

 Today was the day.

I recently wrote about chemotherapy shortages.  They've been in the news more and more over the past 12 months.  But until today, at least in my practice, they were worries.

But now the drug in short supply is methotrexate.

Acute lymphoblastic leukemia (ALL) is the most common cancer in children.  Cancer is the most common cause of death (other than trauma) in children.  Upwards of 80% of children with ALL are cured with modern treatment regimens.

But I don't know how to cure ALL without methotrexate.

Or osteosarcoma.

Or lymphoma.

There are several companies that supply methotrexate in the US, but all are experiencing production or distribution delays or suspensions.  The net result?  We had a meeting today to figure out if we have enough methotrexate to treat our current patients.  And, if we have a shortfall, to figure out who gets treated... and who doesn't.

The good news is we found a few vials we didn't know about yesterday, and for at least the next 2 weeks, all current patients can get treated on schedule.  But, if we don't get another shipment in 2 weeks, or if an adult-sized patient is diagnosed with Burkitt's lymphoma presents to the hospital tomorrow?  We won't have enough drug. 

And someone won't get treated.

I have already discussed the many reasons for drug shortages.  The list of drugs in short supply is mind-bogglingly long.  But we can work around a lack of Zofran.  We can find alternatives for Gentamicin.

But I can't cure ALL without methotrexate.


Anonymous said...

This is a huge concern, my son is in treatment for ALL as I type. Luckily for him, his treatments end in 8 weeks. Methotrexate is a major part of his remaining treatment plan, but it is not him I am worried about. It's the others, the ones who just recently were diagnosed, the ones who are only halfway through their treatment plan....what about them? Our children are our future and without this drug, our ALL kids may not have a future....

Elizabeth Munroz said...

Are TKI's at least helpful?

Erin G. said...

This is one of the saddest things I have heard in a long time. What is being done to help these children? Why hasn't this been on the news? I hope this shortage ends not soon, but right now.

Kathleen Blanchard RN said...

This is sad indeed. Erin G., it's been in the news a lot and parents are responding on the internet that they are heartbroken with worry..and it seems so are the doctors treating ALL kids.

Mary Sorens said...

There are so many people dealing with osteosarcoma who will be affected by this. How do we lobby the government to change this rule? There is no way that a drug company should LOSE money on a life-saving medication, even if it is generic. UGH.

Anonymous said...

What can be done? This is horrendous.

japple_164 said...

This is such a sad thing to hear about, but so good to know about. I find these things interesting to read about and it makes me what to help out in any way that I can. Thank you for bringing this to everyone's attention. Cancer is always a hard thing to deal with, especially when you don't have the right Medicine.

Kathleen Ruddy, St. Baldrick's Foundation said...

Dr. David, thank you for such a moving and truthful article about what the drug shortage means to not only families but pediatric oncologists as well who fight for children’s lives every day. Although the crisis has been temporarily mitigated, the St. Baldrick’s Foundation hopes that this does not happen again – children with cancer and their families already suffer enough. They shouldn’t have to worry about running out of drugs that give their child the best chance for survival. Thank you for sharing your voice in this crisis and for the life-saving work that you do. You are a hero for kids with cancer.

canoehead said...

Can someone explain why another company doesn't pick up the slack, or if the raw materials are ahrd to get, increase the price to ensure sufficient supply? I apologize for my ignorance- just leave me a link and I'll be happy. Thanks.

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