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Implications of the Oncology Drug Shortage

Today’s New York Times fea­tures an op-​​ed by Dr. Ezekiel Emanuel, on the oncology drug shortage. It’s a serious problem that’s had too-​​little attention in the press:

Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment reg­imens used to cure leukemia, lym­phoma and tes­ticular cancer.

Emanuel con­siders that these cancer drug shortages have led to what amounts to an acci­dental rationing of cancer meds. Some des­perate and/​or influ­ential patients (or doctors or hos­pitals) get their planned chemo and the rest, well, don’t.

Unfor­tu­nately, what’s behind this harmful mess is neither a dearth of ingre­dients nor unsolvable problems at most of the man­u­fac­turing plants. Rather, the missing chemother­apies are mainly old and inex­pensive, beyond their patent pro­tection, i.e. they’re not so prof­itable, and not high-​​priority.

Emanuel pro­poses that the prices of old oncology meds – drugs that can cost as little as $3 per dose – be raised so that the com­panies will make it their business to provide them. This seems like a rea­sonable idea, although I find it a bit too com­pro­mising. Why should we raise the costs of any med­ica­tions above what’s nec­essary for their man­u­facture and distribution?

The under­lying problem is that we rely on a profit motive to deliver needed health care in the U.S. This kind of financial incentive, even if you find it morally acceptable, doesn’t seem to be working.

That’s why I favor scrapping the system – in which insurance com­panies siphon off some 30 percent or so of expenses, and phar­ma­ceu­tical com­panies take another big cut — and giving patients the care they need, profits aside.

The health care reform bill of 2010 didn’t go far enough. Not even close.

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