Northeast Ohio hospitals have been hit with shortages of cancer drugs as part of a national shortfall in supply. So far, officials say their patients have been spared negative effects because hospitals have dipped into stockpiles and prescribed other medications that are equally effective.
Northeast Ohio institutions are facing shortages in drugs such as platinum-based chemotherapy drugs, including carboplatinum and cisplatin, and other cancer drugs, including leuvovorin, fluorouracil (5-FU), erythropoietin and methotrexate, according to MetroHealth and University Hospitals officials. Such drugs are commonly used in treating a variety of types of cancer, including lung, gastrointestinal gynecologic, genital and urinary.
Using stockpiles and prescribing different medicines to ones in short supply has meant little impact for UH patients, said Dr. Patricia Roberts, who directs the hospital's cancer pharmacy.
“We have supply that mostly meets our demand because we're so far ahead of the shortage,” she said.
The shortage in cancer drugs is part of an ongoing wave of pharmaceutical shortages affecting the U.S. The number of active drug shortages nationwide peaked at 295 at the end of 2022, according to a U.S. Senate Committee on Homeland Security & Governmental Affairs report.
It is important therefore to plan for shortages and watch for any potential shortfalls, Roberts added.
“Having resources allocated to monitoring drug shortages is now critical in (an) oncology setting," she said. "We need strong resources to keep tabs on these things so that we can continue to treat our patients because it could be extremely disruptive to their care.”
The Cleveland Clinic has a dedicated drug shortage pharmacist, who "helps us navigate and mitigate these shortages," the hospital said in a statement. "In addition, we work closely with manufacturers and supply chain teams."
Other Northeast Ohio hospitals have also been preparing for drug shortages, said Brian Kovach, service line administrator of MetroHealth's Cancer Center.
“It's all about preparedness and having strategies in place to preserve stock on hand and develop alternative therapies and strategies that can lead to the same, if not better clinical outcomes,” he said.
MetroHealth has started a series of clinical trials with new or alternative drug therapies to take the place of treatments that are in short supply, according to the hospital.
At MetroHealth "we're seeing very good patient outcomes" from these studies, said Kovach.
The Cleveland Clinic also prescribes alternative drugs to deal with shortages.
"In some cases, our pharmacists and physicians work together to provide alternate medications or formulations for our patients ...." it said in a statement.
There have also been unexpected consequences as a result of the shortages, said UH's Roberts. Insurance companies have become more flexible in what drugs they are willing to pay for, she said.
But the pivot to other drugs can trigger a new shortage.
“There’s been a sort of teeter-totter effect," as one shortage leads to another, Roberts said.
The federal government is also looking to foreign manufacturers to bolster supply, she said.
"I have read recently that the (Food and Drug Administration) is looking to allow certain external manufacturers and non-United States manufacturers that aren't approved through the FDA at this point in time to import product," Roberts said.
The FDA announced in May it had begun authorizing Chinese manufacturer Qilu Pharmaceutical Co. Ltd. to import cisplatin to the United States.
