San Diego Patients Not Going Without Cancer Drug Amid National Shortage
Monday, October 28, 2019
The national shortage of a cancer drug commonly used to treat kids has caused anxiety across the country, but facilities in San Diego aren’t affected by the limited supply.
Oncologists use vincristine to treat a wide range of childhood cancers, including neuroblastoma, brain tumors and lymphomas. One of two manufacturers recently stopped making the chemotherapy drug while the other experienced production delays. Medical professionals reported difficulties accessing the drug, prompting nationwide fear, including in Illinois, Iowa and South Carolina, that patients would be forced to skip treatments.
At least one parent in Missouri said her child, who is in remission, wouldn’t receive vincristine during an upcoming treatment due to rationing, according to ABC News.
However, facilities in San Diego and Imperial counties were unscathed by the shortage, and shipments of the drug recently resumed.
A Rady Children’s Hospital spokesman said on Friday the facility has adequate supply to meet its young patient’s needs. UC San Diego Health spokeswoman Yadira Galindo said doctors there didn’t report issues with supply. Galindo said the health system doesn’t treat children with cancer but vincristine is also used for some adult cancers.
The Cancer Resource Center of the Desert in El Centro said it has also not heard from patients who can’t get the drug.
Dr. Erin Boatsman, a pediatric oncologist at Kaiser Permanente in San Diego, said drug shortages aren't uncommon in the field, partially because there are fewer pediatric patients compared to adults and therefore not as many companies make cancer drugs for kids.
"When you have a manufacturing problem — either they can't get the raw material or again, there was a bacterial contamination for example — then that really impacts the supply that's available," Boatsman said.
She said a shortage doesn't mean kids go without the medication because chemotherapy treatments include a mixture of drugs.
"If one of them is in short supply and the child had to go without it there are other drugs in the regimen that they do continue to get," she said.
Children who are in urgent need are prioritized during times of limited supply, she said.
Rady oncologist Dr. Deborah Schiff said the vincristine shortage caused greater concern because it is widely used and has been for decades.
"The special thing about vincristine is it's used for so many different types of childhood cancer — leukemia, brain tumors, other solid tumors affecting the bone and the muscle — so it impacts more than some of the other medications that are on shortage," Schiff said.
The Children’s Oncology Group or COG, which represents more than 200 children’s hospitals, said earlier this month that some pharmacists at its member sites were unable to acquire the drug.
“We are greatly concerned that some children are already being impacted by this shortage and by the understandable anxiety this creates for all families of children with cancer,” Dr. Peter Adamson, the group’s chair, said in an Oct. 16 letter.
Problems accessing vincristine began after Teva Pharmaceuticals ceased production of the substance in July. The move was a “business decision,” according to the Food and Drug Administration’s drug shortages website.
Additionally, Pfizer, the only other producer of vincristine experienced a “manufacturing delay,” the FDA's site said. But the pharmaceutical company said it had increased production to meet demand.
“We have also expedited additional shipments of vincristine, which are now in transit to healthcare providers so they can treat patients,” the company said in an Oct. 18 statement.
Pfizer said in a customer letter it plans to meet the need for the rest of the year and have customers fully stocked by January. The company also expects to have at least eight weeks of supply on hand by that time, according to a spokeswoman.
Adamson, chair of the Children’s Oncology Group, said in an online webinar last week that he spoke with Pfizer about its vincristine distribution plan. He said the company is filling orders but also creating a reserve supply so it has product immediately available if a child is in urgent need of the drug.
Adamson called on the cancer community in his Oct. 16 letter to develop and advocate around policies that can help prevent drug shortages, which he said have become more frequent over the last decade.
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