How an Oncology Pharmacist Views the Nationwide Drug Shortage

Drug Information

Worst drug shortage ever seen by veteran pharmacist with two decades of experience

Sep 26, 2023

Jessica Levco

Neal Dave, Executive Director of Pharmacy at Texas Oncology, has been a pharmacist for 18 years. He says we’re living in the worst drug shortage crisis he’s ever seen.

“I’d rank this as the worst because of the amount of products that have been affected,” Dave says. “The two big shortages that are affecting cancer patients are the platinum compounds: cisplatin and carboplatin. A lot of times, you may be able to substitute one for the other in a treatment regimen, but now, we’re low on both.”

Dave says the current drug shortage is because a pharmaceutical company in India that supplied both carboplatin and cisplatin to pharmacies across the U.S. had quality control issues, causing it to shut down. But it’s not just cancer drugs that are tough to get. He’s also seen supportive care drugs that have been harder to reach, such as: Elitek, Infed, Lidocaine, Retacrit, Soludortef, Solumedrol, Fluorouracil Methotrexate and Docetaxel.

Neal Dave, Executive Director of Pharmacy at Texas Oncology

“The two big shortages that are affecting cancer patients are the platinum compounds: cisplatin and carboplatin. A lot of times, you may be able to substitute one for the other in a treatment regimen, but now, we’re low on both.”

However, he remains optimistic that the market will stabilize. He suspects another manufacturer will enter the market to boost supplies. Currently, the FDA is importing some cancer drugs from other countries.

So far, all Texas Oncology cancer patients have been able to get the treatment they need. However, doctors have been asked to prioritize patients based off their treatment regimen or offer alternative treatments, if they are available and effective.

“Sometimes, we’ll need to pivot on treatment,” Dave says. “Sometimes, the alternative treatment to carboplatin is cisplatin, or the alternative to cisplatin is carboplatin. We’re trying to manage, depending on which one has a slightly better supply. It’s a seesaw we’ve been on.”

Dave thinks there are a few things the federal government could do to help, such as:

Import carboplatin faster. “Cisplatin was imported in July and we immediately saw some stabilization of supply,” Dave says.
Incentivize manufacturers to make life-saving cancer treatments. “A lot of manufacturers have left the market specifically with carboplatin because it costs more to make the drug than the money they get back,” Dave says.
Create some kind of reimbursement for generic drugs and stabilize some of the pricing for manufacturers. “Reimbursement for a generic drug is essentially the cap of what a manufacturer can charge for the drug,” Dave says. “Over the years, some manufacturers have stopped making products, such as carboplatin, because they were selling the product at a loss.”