A news story recently in the New York Times
has unveiled a growing concern among pediatric oncologists and health
care institutions at large. The injectable form of preservative free
methotrexate, commonly used to treat pediatric patients with leukemia and osteosarcoma, is in short supply.
The bigger drug shortage picture
Drug shortages are an increasingly frequent and serious problem affecting health care organizations across the country.
"A
number of contributing factors are causing these shortages, such as raw
material unavailability, manufacturing difficulties and regulatory
issues, voluntary recalls related to manufacturing problems, changes in
medication formulation, and industry consolidations and economic
decisions," says Wendy Heck, Pharm.D., manager of drug information and
drug use policy at MD Anderson Cancer Center.
Regardless of the
cause, drug shortages create great frustration for everyone involved,
including purchasing agents, pharmacists, nurses, physicians, and
patients. Fortunately, not all national drug shortages will go on to
affect MD Anderson.
"We meet weekly to review current drug
shortages. If a shortage does reach MD Anderson, our team works
diligently to develop a management plan to minimize the impact on our
patients," says Joel Lajeunesse, vice president of the Division of
Pharmacy. "For now, we have sufficient supplies of methotrexate for our
patients."
Pediatric oncologists at MD Anderson Children's Cancer Hospital work closely with pharmacists to manage the supply of methotrexate for pediatric patients. The most recent concern involves the preservative free form of injectable methotrexate. This form is commonly used for intrathecal, or spinal cord, injections because it lowers the risk for neurotoxicities, such as paralysis.
"We've been dealing with drug shortages in pediatric oncology for a while now, whether it stems from lack of development or discontinuation of production," says Patrick Zweidler-McKay, M.D., Ph.D., section chief of leukemia at the Children's Cancer Hospital. "It's not as profitable for companies to make drugs for rarer cancers, such as childhood cancer. However, this situation involves vital standard-of-care drugs, and we can't get a consistent supply of them. Something must be done for our patients' sake."
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Photo by Stuart Isett for The New York Times
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