3 pressing drug shortages, per Dr. Erin Fox

As the U.S. grapples with a 10-year-high of ongoing drug shortages, there are three pressing drug supply issues for hospitals, according to Erin Fox, PharmD, associate chief pharmacy officer for shared services at Salt Lake City-based University of Utah Health. 

The three "most concerning shortages" are all cancer treatments, said Dr. Fox, who also works on the American Society of Health-System Pharmacists' drug shortage database.

"Unfortunately, we're not getting a lot of good communication from the companies involved about how much they can supply and when they're going to be able to resupply," she said. "I think everybody's really nervous."

When hospitals do not know how much drug is in stock, when they can get more or how much resupply they can expect, patient care decisions are further complicated, Dr. Fox said.

Three pressing drug shortages:

1. Supply of methotrexate, a medication for acute lymphoblastic leukemia, breast cancer, lung cancer, and certain types of head and neck cancer, was thrown into chaos after the Supreme Court overturned Roe v. Wade because one of its side effects is ending a pregnancy. 

There are no available solutions available as five drugmakers report shortages, according to an April 13 update from the ASHP. 

2. Cisplatin injection is approved for bladder cancer patients and is used off-label for squamous cell head and neck cancer, cervical cancer, lung cancer, osteosarcoma, esophageal cancer, adrenal cortex carcinoma, breast cancer, endometrial cancer and liver cancer, according to the ASHP

As of April 26, 10 solutions are on back order or allocation while one solution is available. Most drugmakers did not provide an estimated resupply date, and Fresenius Kabi said its three backordered solutions would be available again between April and June.

3. Ovarian cancer drug carboplatin injection — which was in short supply from 2015 through 2018 — is in shortage again, according to the ASHP. As of April 26, 14 solutions are unavailable and one is on the market. Among the drugmakers that shared predicted release dates, resupply is expected between May and August. 

"People are spending a lot of time, which we have to do, to mitigate the impact on patients, but it's such a waste of time to have people every week count up the vials, run your inventory report," Dr. Fox said, as they try to answer questions such as, "'Are we going to have enough drug this week? Are we going to have enough drug today? Are we going to have enough drug for the afternoon?' It's very stressful on the staff and it's stressful for patients."

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