Chemotherapy Shortages Affecting Hematologic Cancers Due to Production Issues

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Julie M. Vose, MD, MBA, reflects on the generic drug shortages and the reasoning behind the continued pattern affecting different cancer types.

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      As the drug shortages continue, a new wave is now affecting the hematologic cancer space. Currently, vinblastine and dacarbazine, most commonly used with curative intent in pediatric cancers are in short supply, according to Julie M. Vose, MD, MBA.

      Vose, division chief, Neumann M. and Mildred E. Harris Professor in the division of hematology and oncology at the University of Nebraska Medical Center, spoke to some potential reasons that may have resulted in this shortage within the hematologic cancer space. In particular, she highlighted that delays in the production process, manufacturing issues, or a shipping could be the cause of this new shortage. She indicated that because the agents are older with few manufacturers, if one facility experiences issues, production can be put in jeopardy.

      Moreover, Vose indicated that more needs to be done to encourage other manufacturers to produce these agents to solve the challenge on a global scale.

      Transcript:

      There are a number of reasons for these [drug] shortages. These are all generic drugs. They’re typically only made by 1 or 2 manufacturers, because there’s not a lot of profit to be made from these drugs; they’re very old. If one factory goes down from a quality control issue then, unfortunately, that causes a major problem. Since there aren't a lot of factories making these drugs, the profit margin isn’t there. Some of it is a quality control issue, and some of it is just that there is no backup [supply] if there's a problem.

      Previously, there were weather problems in certain areas that caused problems with manufacturing, quality control problems, and shipping problems. There are all kinds of issues that can cause problems. If there’s no backup, then even a small minor thing can cause problems with getting the drug supply through. What needs to be done is to try to find a better way to encourage companies to manufacture these drugs. I’m not sure of the methodology for doing that, but it is a major problem since we still use many of these agents for a lot of curative types of malignancies. We really need to be able to solve this problem worldwide, not just in the United States.

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