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Drug shortages endanger cancer patients



Shortages of crucial cancer drugs are threatening the care of patients who are already fighting for their lives, a new study shows.

About 83% of cancer specialists reported a drug shortage in the past six months, and 92% said patients' care has been affected, says the survey of 245 doctors presented Monday at the Chicago meeting of the American Society of Clinical Oncology.

The survey found 38% of doctors switched from a generic to a name-brand drug, which can vastly increase the cost of treatment, says the study, co-written by Keerthi Gogineni at the University of Pennsylvania School of Medicine.

The oral drug capecitabine, for example, costs 140 times as much as a generic intravenous drug, 5-FU, which is the backbone of chemotherapy regimens for many gastrointestinal tumors.

There were 251 drug shortages of all kinds in 2011 and 121 in 2012, according to the Food and Drug Administration. Most of the drug shortages have been the result of problems in manufacturing processes that shut down production, the FDA says.

Some hospitals hold the equivalent of lotteries to decide which patients receive a drug, says cancer researcher William Li, executive director of the Angiogenesis Foundation, which sponsors research of blood vessel growth.

A study in December from St. Jude Children's Research Hospital linked drug shortages to higher relapse rates among young people with Hodgkin lymphoma. The number of patients who were cancer-free after two years fell from 88% before the shortage to 75% after doctors had to substitute an alternate drug.

Many of the shortages involve sterile injectable drugs commonly used in oncology, Gogineni says.

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