Study: Drug short­age hurts can­cer pa­tients

Re­lapse more likely in pa­tients forced to use sub­sti­tute treat­ments.

Austin American-Statesman - - ADS - By Marilynn Marchione

Young can­cer pa­tients who couldn’t get a key medicine be­cause of a na­tional drug short­age were more likely to suf­fer a re­lapse than oth­ers who were able to get the pre­ferred treat­ment, doc­tors report. It’s the first ev­i­dence that a long-stand­ing drug-sup­ply prob­lem prob­a­bly has af­fected can­cer treat­ment re­sults in spe­cific pa­tients.

The study in­volved more than 200 chil­dren and young adults with a blood can­cer called Hodgkin lym­phoma. Like child­hood leukemia, it can be cured nearly 80 per­cent of the time. But a drug short­age that has wors­ened since 2009 is threat­en­ing that success rate, doc­tors report in to­day’s New Eng­land Jour­nal of Medicine.

Hun­dreds of drugs, in­clud­ing an­tibi­otics, painkillers and can­cer treat­ments, have gone in and out of short sup­ply in re­cent years. Rea­sons in­clude man­u­fac­tur­ing and con­tam­i­na­tion prob­lems, plant shut­downs, and fewer mak­ers and lower prof­its for cer­tain drugs, es­pe­cially gener­ics in­fused dur­ing surgery or can­cer treat­ment.

Doc­tors some­times sub­sti­tute dif­fer­ent drugs for ones in short sup­ply. But prov­ing that the swaps led to poorer re­sults has been tough, es­pe­cially for can­cer pa­tients whose disease and re­sponse to treat­ment vary so much.

“We really couldn’t put our fin­ger on, did any­body really suf­fer?” said Dr. Michael Link, a can­cer spe­cial­ist at Stan­ford Univer­sity.

The new study, led by Dr. Monika Met­zger of St. Jude Chil­dren’s Re­search Hospi­tal in Mem­phis, gives the best ev­i­dence so far that pa­tients are suf­fer­ing.

It fo­cused on mechlorethamine, or ni­tro­gen mus­tard, a drug that has been in short sup­ply un­til last month, when more be­came avail­able. Doc­tors com­pared re­sults among 181 Hodgkin lym­phoma pa­tients who re­ceived the drug with 40 oth­ers who were given a dif­fer­ent chemo­ther­apy. Only 75 per­cent of those given the sub­sti­tute drug stayed free of can­cer for two years ver­sus 88 per­cent who re­ceived the pre­ferred treat­ment.

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