Imagine being a parent with a child fighting cancer and being told there was a shortage looming for a drug needed to keep your child alive.
That shocking news swept the nation a few days ago when it was predicted we could run out of the standard treatment for the most common childhood cancer by the end of the week.
The FDA followed that prediction by announcing they diverted the shortage, but Memorial Children's Hospital, which treats 15 to 20 children at any time, is watching the situation very closely.
Maureen McFadden sat down with one of their pediatric oncologists, who said their pharmacy hasn't received a new supply of the much needed drug yet.
While bright paint and murals greet children entering Memorial Children's Hospital Pediatric Oncology Unit, the little people who walk these halls are facing life threatening illnesses.
One of the four US makers of preservative free methotrexate, the mainstay for treating and curing Acute Lymphoblastic Leukemia, or ALL, shut down and the other three manufacturers did not increase production.
Pediatric Oncologist Dr. Colleen Morrison said unfortunately the demand for this drug is even higher for saving young lives. “More of them now than ever before receive a high dose formulation of the drug. The outcomes, meaning survival, was much better with the high dose version of the drug.”
It's a drug that is used at Memorial each and every day, with kids needing 25 spinal taps of methotrexate over several months for a cure.
Dr. Morrison says in spite of the FDA announcement that the remaining plants will ramp up production, there is still real fear. “We currently have two patients here Thursday who need methotrexate, and we have enough for them. We do not know about the next two to three weeks.”
The generic methotrexate is the gold standard, but unfortunately the manufacturers of generics have struggled making investments in their plants. “A lot of people believe that maybe the incentives are not there for the company. It's not as lucrative to produce this drug in comparison to others," Dr. Morrison said. She continued, “I believe that the reimbursement for the generic drugs is poor. So whether it's incentive or not they may be limited due to the reimbursement.”
Dr. Morrison said Memorial parents and the Chair of the Children Oncology Group have made their position to lawmakers clear. She added we don't want to get to a point where doctors have to prioritize who gets the drug and who gets an alternative. “The shortage is unacceptable, and in this country, we really should be able to deliver the medicine that children need."
More than 200 drugs in this country are facing shortages, including many other cancer drugs.
Dr. Morrison said that getting the drug from other countries is a possiblity, but we have to be careful to make sure the qualitity is not comprimised. "One of the conversations between the FDA and the Chair of the Children Oncology group did refer to other sources or other sources of the drug is we needed to go that route," Dr. Morrison said. "Certainly the German group is a huge leader in the treatement of children cancers."