Navigating the Impact of Chemotherapy Shortages on Cancer Care and Finances

CancerNetwork^® spoke with experts across multiple disciplines about the far-reaching impacts of the ongoing shortages of chemotherapy drugs including carboplatin and cisplatin, and how practices may be able to mitigate these challenges in the short and long term.

Michael Ganio, PharmD, MS, BCPS, FASHP, described the causes of carboplatin and cisplatin being in short supply across the United States and how the FDA is working with Chinese manufacturers to import these chemotherapy agents. Ganio, senior director of Pharmacy Practice and Quality at the American Society of Health-System Pharmacists, stated that communication is paramount among all members of a care team to help prevent critical errors while treating patients with limited supplies of these drugs. He also spoke about how reaching out to local representatives may help address the issues resulting from these shortages.

“Advocacy is needed,” Ganio said. “Our policymakers need to know that these shortages are having a real-world impact, and that they need to be addressed.”

Brian Slomovitz, MD, MS, FACOG, spoke about how he is managing the ongoing shortages in the context of his gynecologic cancer care, including swapping one platinum-based drug for another during treatment. Slomovitz, a gynecologic oncologist, director of Gynecologic Oncology, and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida and a professor of Obstetrics and Gynecology at Florida International University, also described the challenges many practices across the country have due to lacking platinum-based drugs altogether.

“I know there are institutions that don't have [platinum-based chemotherapy],” Slomovitz said. “There are institutions that aren't able to give their patients the best standard-of-care therapy and aren't able to enroll patients in trials because of lack of therapy.”

Lucio N. Gordan, MD, addressed the financial impacts of these shortages, discussing how his practice has managed the rising prices of carboplatin and cisplatin in the country. Gordan, president and managing physician at Florida Cancer Specialists & Research Institute who sees patients in the state-wide practice's Gainesville Cancer Center, stated that efforts from major oncology organizations may help increase adequate access to chemotherapy drugs.

“It's very important that the large practices and institutions in the country stay united,” Gordan said. “The Community Oncology Alliance [COA], American Society of Clinical Oncology [ASCO], and others are trying to push legislation that would protect the consumer, the patients, and us to make sure that we have a proven supply.”

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Reference

Temporary importation of CISplatin injection with non-U.S. labeling to address drug shortage. FDA. May 24, 2023. Accessed September 13, 2023. https://shorturl.at/eiPQZ