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available drugs. “One of the Official tennessee Volunteers 2023 NCAA Division I Softball Super Regional shirt Besides,I will do this issues though with these alternative medications is often they’re not as good, so it may compromise survival outcomes,” said Dr. Angeles Alvarez Secord, president of the Society of Gynecologic Oncology. In addition, “when there’s more toxicity, there’s more cost to the treatment because you’re also dealing with the side effects, or giving additional drugs to try to prevent the side effects,” Secord said. “So the alternatives often, even though they’re present, are still not meeting the best standard of care.” Nationwide, hospitals and cancer centers have been forced to make similar decisions when it comes to cancer care. According to a May survey conducted by the Society of Gynecologic Oncology, doctors in at least 40 states have at least one chemotherapy drug in shortage. More news about drug shortages Drug shortages are rising and pose a national security risk, new report warns Shortage of penicillin adds challenges to treating syphilis Pharmacies are reporting shortages of the widely used antibiotic amoxicillin Dr. Eleonora Teplinsky, a breast and gynecologic medical oncologist at Valley Health System in New Jersey, said the shortages are devastating. “Cancer is life-changing as it is but you expect as a patient that you’re going to walk into an office and be given the very best that exists,” Teplinsky said. “And right now we don’t have the very best to give in certain cancers.” Recommended ABORTION RIGHTS Indiana board reprimands Dr. Caitlin Bernard over 10-year-old’s abortion case IMMIGRATION More than a quarter of DACA recipients are uninsured as they await the fate of health care rule Drug shortages cause extra stress not only for cancer patients, but for medical providers as well. On top of being in a workforce that’s already burned out and exhausted from a pandemic, doctors have to scramble to find lifesaving treatments. “All the practices in the country, not only in oncology, we have been stressed out much more since Covid,” Gordan said. “This is another curveball that impedes us to do the best

we can.” Shortages can sometimes catch providers off guard. Suppliers don’t give warning when a drug is about to be in shortage; they’ll just stop filling all of their orders, said Andrea Iannucci, the Official tennessee Volunteers 2023 NCAA Division I Softball Super Regional shirt Besides,I will do this assistant chief pharmacist at UC Davis Health. “So we place an order, and we think it’s going to arrive and it doesn’t, because the drug was unavailable,” Iannucci said. Keri Carvill, 44, of Sacramento, California, was diagnosed with triple-negative breast cancer in March but wasn’t able to get her first dose of carboplatin until May 19. Triple-negative breast cancer is a particularly aggressive form of the disease. “It’s stressful and scary,” Carvill said. What led to the shortage and what can fix it? The current carboplatin shortage was caused in part by quality concerns at one manufacturing facility, Intas Pharmaceuticals, in India, but experts say the real problem is more chronic. “Unfortunately, the profitability of this industry is very low or nonexistent,” Califf said. “A number of firms are going either out of business, or they’re having quality problems because of difficulty investing in their technology. That’s the core underlying reason for the shortage that we’re seeing.” In a statement to NBC News, Intas Pharmaceuticals said it is working with the FDA to release existing inventory of carboplatin and other medically necessary products. It is also working with the agency on a plan to resume manufacturing, but added that a date has not yet been confirmed for when that will happen. Califf said the FDA is working with additional manufacturers to make more carboplatin available. Long-term solutions, however, are going to require “intervention by Congress and the White House in order to get this industry in the right place,” he said, adding that a White House team has been working on the drug shortage issue. Teplinsky, the oncologist in New Jersey, said she’s been encouraging her social media followers to reach out to elected officials to advocate for timely production of chemotherapy drugs and long-term policies to ensure this doesn’t happen again. “Delaying care impacts outcomes,” Teplinsky said. “And so in this case, either we can’t give people what they need, or we have to wait, which we know will lead to negative consequences.”Follow NBC HEALTH on Twitter & Facebook. Marina Kopf Marina Kopf is a production assistant with the NBC News Health and Medical Unit. Catie Beck Catie Beck is a correspondent with NBC News.

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