Health Facilities Across Country 'Grappling With Limited Resources' Amid Drug Shortage How They're Managing and What Patients Can Do

Platinum-based chemotherapies (which also include cisplatin) are used to treat several types of cancer including bladder, lung, ovarian, and testicular cancers.

“We are managing one of the worst drug shortages of our time,” Florida Cancer Specialists & Research Institute President & Managing Physician Lucio N. Gordan told SurvivorNet.

The community-based hospitals we spoke to confirmed they are in short supply of their cancer drugs. And of the 27 member cancer centers surveyed by the NCCN, nearly all reported they were in a shortage of carboplatin while 70% reported they were short on cisplatin.

“Over the past three months we have been monitoring our supply of carboplatin, as well as several other drugs used to treat cancer. Our supplies of carboplatin, used to treat numerous cancers, are severely low,” Dr. Gordan added.

“Thousands of our patients, and hundreds of thousands of patients across the country, depend on [these] as a life-saving form of treatment,” he said.

The drug shortage alarming many healthcare facilities has been building for a few years now. A government report released in March says drug shortages increased nearly 30% from 2021 to 2022.

The situation grew earlier this year when the Food and Drug Administration alerted healthcare providers and drug pharmaceutical companies of the drug shortage. Drugs used in hospital emergency rooms to treat cancer, prescription medications, and common over-the-counter medications have all been impacted.

"Drug shortages severely hamper a hospital's ability to provide patients with the best treatment," said Michigan Health and Hospital Association (MHA) CEO Brian Peters.

Overall, doctors and centers are working hard to make sure patients are treated.

According to the NCCN, centers said the cisplatin shortage is not as bad as the carboplatin, and all reported they are able to continue treating patients who need the drug.

When it comes to carboplatin, 64% of surveyed centers said they are able to continue treating all patients, while 20% said they can only treat some.

Within the state of Michigan, the drug shortage is forcing some hospitals to find other treatments for patients.

A spokesperson for MHA told SurvivorNet that Michigan hospitals are trying different solutions to mitigate severe impacts. These solutions include managing existing supply, seeking alternative sources for cancer drugs in short supply, and adjusting chemotherapy regimens for impacted patients.

However, Peters says these alternative strategies may "increase the cost of care" and do not offer the "same effectiveness in treatment,” introducing significant challenges for cancer patients.

WATCH: Get Help Paying the Cancer Bills

Texas Oncology provides community-based cancer care, with 530 physicians and 280 locations throughout Texas and Oklahoma. Spokesperson Krystal Morris tells SurvivorNet that Texas Oncology is monitoring the cancer drug shortage closely and “a small number of patients have been affected” within their network.

“We are working with them closely to determine alternative treatment options to ensure they continue to get the cancer care they need…In some cases, that may require changes in the drug regimen or treatment schedule to ensure that treatment continues without interruption,” Morris added.

Allegheny Health Network (AHN) told SurvivorNet they’re also monitoring their supply closely.

“To minimize the impact of shortages on patients, AHN is employing many different solutions, including managing existing supply, seeking alternative sources for drugs in short supply, adjusting chemotherapy regimens for impacted patients, and working with healthcare providers, to mitigate these challenges,” said Jodi Lech, Pharm.D., BCOP, Director of Pharmacy, Hematology/Oncology at AHN.

“The Oncology Pharmacy team and its centralized distribution center are actively monitoring the daily supply situation to align best with patient needs,” she added.

The Minnesota Hospital Association tells SurvivorNet a few of its hospitals and healthcare partners are dealing with drug shortages.

And City of Hope is a network of comprehensive cancer care centers across California, Arizona, Georgia and Illinois. However, chief medical officer Dr. Vijay Trisal toldSurvivorNet, "Like many other hospitals and health care systems nationwide, City of Hope is affected by the national shortage of certain chemotherapy drugs.”

"We are developing mitigation strategies through a dedicated team of integrated staff across our national cancer care system. We remain committed to using every available resource in providing the very best care for our patients," Dr. Trisal continued.

The Difference Between Community Facilities and Large Cancer Centers

It’s important to remember that public community hospitals are owned and operated by state or local governments and provide healthcare for many people, especially the uninsured. Community hospitals may provide some cancer care including surgery, radiation, and chemotherapy treatments.

On the other hand, large cancer centers tend to provide higher levels of cancer-specific care that meet rigorous standards. These facilities tend to be affiliated with medical universities but can also be freestanding.

What Patients Can Do If Their Cancer Medication Is Not Available

If you happen to be on the receiving end of a drug shortage, you may be wondering what can you do. SurvivorNet recommends speaking with patient navigators or a social worker that may be available to you.

It is important you consider the following when speaking with the patient navigator or social worker:

Aggressively push for solid answers. If you can, bring someone with you to your doctor’s appointment to help you take notes and get the necessary answers you need.

Consider all of your treatment options, and this includes alternative treatments. If the cancer drug you’re used to getting is not available, talk to your doctor about some substitutes that will be just as effective.

As SurvivorNet’s quest for answers to the drug shortage revealed, drug supply varies across different hospitals and healthcare facilities. If your regular doctor is in short supply, call neighboring healthcare facilities to see if they have the drug you need. If they have the drug you need, you may need to travel to get it.

WATCH: Carboplatin is among the drugs in short supply. It’s commonly used to treat ovarian cancer.

What Caused the Drug Shortage?

The drug shortage has been on the horizon for years, as some lawmakers pointed out in previously released reports. There is speculation that drug makers producing older chemotherapy drugs have little incentive to maintain large-scale production because they are no longer patent protected.

Once the patent expires, the drugs become less profitable as the generic drug market takes hold.

Other areas of concern involve disruptions in the drug manufacturer supply chain. The New York Times previously reported on problems at manufacturing plants in China and India disrupting the flow of key ingredients needed to produce the drugs.

The overseas drug manufacturers themselves have also experienced production slowdowns due to quality control issues. The FDA released a report on India-based Intas Pharmaceuticals claiming it “lacked adequate oversight” during an inspection last year.

Dr. Gordan of Florida Cancer Specialists highlighted these issues: “The root causes include low price point of some generics below the cost of production, relative low investment in this business line. At this point we are in critical need of change. Our practice has joined many others in the oncology community to ask for legislative support in regulation of pricing for these crucial drugs.”

U.S.-based drug companies ramped up production of needed drugs to fill the void but supplies have not reached healthcare facilities in large quantities just yet.

Fresenius Kabi produces carboplatin and a spokesperson for the company previously told SurvivorNet that it has “prioritized production” of the drug to help compensate for the shortage. “However, it will take several weeks to ramp up the production.”

Is Anything Being Done to Prevent Future Drug Shortages?

Physicians and healthcare organizations who spoke to SurvivorNet want the government to do more to prevent future drug shortages.

The Michigan Health and Hospital Association said it supports "removing regulatory obstacles faced by manufacturers and the FDA" to get drugs imported faster, allowing them to get to patients in a timely manner without the risk of a shortage.

U.S. senators and representatives from Michigan sent a joint letter to the FDA asking the federal agency to "do everything in its power to mitigate the dire shortage of cancer drugs that have reached crisis levels."

The lawmakers pointed to a "broken economic system in the generic drug industry" as part of the blame for the situation.

An estimated “91% of all prescriptions in the United States are filled as generic drugs,” according to the FDA. Generic drugs are FDA-approved drugs that meet the same standards as brand-name drugs.

However, the biggest difference for consumers is they cost “an estimated 80 to 85% less” than brand-name drugs.

“Generic drugs tend to cost less than their brand-name counterparts because generic drug applicants do not have to repeat animal and clinical studies that were required of the brand-name medicines to demonstrate safety and effectiveness,” the FDA explains.

Michigan Sen. Gary Peters released a report in December 2019 highlighting the potential consequences of the United States’ overreliance on foreign generic drug manufacturing facilities. The report found “nearly 80%” of manufacturing facilities for critical generic drugs used in hospitals were outside the country.

Any production disruptions overseas would severely impact hospitals, healthcare providers, and patients.

In May, the House Energy and Commerce Committee held a hearing on the drug shortage.

"Our committee has exposed the harmful consequences of consolidation, federal programs, and malincentives that distort the market and make it more difficult for patients to get lower-cost medication," House Energy and Commerce Committee Chair Cathy McMorris Rodgers said.

"These market distortions hinder the adoption of quality generic drugs and weaken the drug supply chain," Rogers continued.

During a Senate Homeland Security and Governmental Affairs Committee hearing in March, Sen. Peters highlighted the consequences of the drug shortage.

"These shortages, which reached a peak of 295 individual drugs in shortage at the end of 2022, have left health care professionals grappling with limited resources to treat patients in need," Senate Homeland Security and Governmental Affairs Committee Chairman Gary Peters said at a hearing.

NBC News reports Sen. Peters is working on legislation to help mitigate future drug shortages.

The FDA shared with CNBC it’s considering, “allowing the temporary importation of chemotherapy drugs from overseas manufacturers that are not currently approved to distribute in the United States.”

Questions for Your Doctor

If you find yourself facing a shortage of your specific cancer medication, consider asking your doctor the following questions to help understand your situation and what help is available to you:

• What does supply look like for the drug I'm taking? Is there enough to go around?
• What other treatment options exist for me in case my cancer medication is in short supply?
• Will these other options be as effective to help treat my cancer?
• If I need to travel farther away for my cancer medication, am I eligible for transportation assistance?
• If I'm worried about managing the costs of cancer care, who can help me?
• What support services are available to me? To my family?

Help Paying the Bills

If you find yourself faced with higher cancer bills because your treatment had to be adjusted, or you now need to travel further to receive treatment, know that there are resources available to help.

A social worker at your health facility can help guide you through the various options. Patient advocacy groups are also willing to help in several ways and your church or social group may be another source of support.

Here are some examples of programs and organizations that may be able to help with bills associated with cancer treatment:

For Help With Treatment Bills

• The Cancer Financial Assistance Coalition can direct patients and their families to available local services.
• Many treatment centers offer extended payment plans and some may offer temporary payment delays, according to the American Cancer Society.
• CancerCare, which connects patients with oncology social workers, may be able to assist with co-pays, transportation, and other costs associated with care.
• The HealthWell Foundation may be able to help uninsured patients pay for treatment.
• The American Cancer Society may be able to link patients and their families up with local resources (they offer a 24/7 helpline).
• The Patient Advocate Foundation (PAF) works with patients and their insurance companies to resolve issues and may provide direct financial support to some patients.
• The Patient Access Network Foundation may be able to help with out-of-pocket costs associated with cancer treatment.

For Help With Transportation and/or Housing

• There are several programs that may be able to assist patients if they need to travel by plane to get treatment, including Air Care Alliance, the Corporate Angel Network, and PALS (Patient Airlift Services).
• Patients with Medicaid may be entitled to help paying for transportation costs to and from treatment.
• The American Cancer Society’s Road to Recovery program can hook patients and their families up with volunteer drivers.
• Mercy Medical Angels may be able to help patients and their families pay for transportation.
• The Healthcare Hospitality Network can assist with housing if a patient must be treated far from home.
• The American Cancer Society Hope Lodge Program gives patients and their caregivers a free place to stay during treatment in dozens of cities across the U.S. and Puerto Rico.

For Help With Food

• Food assistance may be available to people going through cancer treatment and their caregivers. Look into the Supplemental Nutrition Assistance Program – aka SNAP – or a program like Meals on Wheels.

Learn more about SurvivorNet's rigorous medical review process.

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