List of Drugs in Short Supply...Xeloda, Cisplatin

[Sheila]

Hard to read but surprised to find common chemo drugs on here....Capecitabine (Xeloda), Cisplatin, Metformin, ...not sad to see Dexamethasone on here.....not my favorite. If you have questions, you should ask your Dr or pharmacist about the recalls/shortages.


Drug Shortages: Current Drugs

ASHP and its partners works to keep the public informed of the most current drug shortages. Shortages can adversely affect drug therapy, compromise or delay medical procedures, and result in medication errors.
Current Drug Shortage Bulletins

http://www.ashp.org/images/hp_rss_icon.png (http://www.ashp.org/rss/shortages/#current) RSS Learn About RSS (http://www.ashp.org/menu/News/RSSFeeds.aspx) Sort by: Generic Name (http://www.ashp.org/DrugShortages/Current/?sort=1) | Revision Date (http://www.ashp.org/DrugShortages/Current/?sort=2)
Generic NameRevision DateAcetaminophen Suppositories (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=660)July 18, 2011Acetazolamide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=463)July 22, 2011Acetylcysteine Inhalation Solution (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=761)July 22, 2011Acyclovir Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=467)July 27, 2011Acyclovir Capsules and Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=591)July 12, 2011Alcohol Dehydrated Injection (Ethanol) (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=778)August 05, 2011Alprostadil Products (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=474)June 28, 2011Amikacin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=501)July 20, 2011Aminocaproic Acid Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=789)July 22, 2011Aminophylline Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=705)July 22, 2011Amiodarone Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=358)July 14, 2011Ammonium Chloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=686)July 20, 2011Ammonium Molybdate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=783)July 22, 2011Amphetamine Mixed Salts, Extended-Release Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=577)July 18, 2011Ampicillin Sulbactam (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=805)July 28, 2011Arginine 10% Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=690)August 02, 2011Aripiprazole Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=791)July 26, 2011Ascorbic Acid Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=615)July 20, 2011Atropine Sulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=814)August 02, 2011Azathioprine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=794)August 03, 2011Azithromycin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=767)July 28, 2011Betamethasone Acetate and Sodium Phosphate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=469)August 02, 2011Bisacodyl Enema (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=760)July 27, 2011Black Widow Antivenin (Latrodectus Mactans) (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=670)July 26, 2011Bleomycin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=276)August 03, 2011Budesonide Inhalation Suspension (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=753)June 28, 2011Bupivacaine with epinephrine injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=723)July 28, 2011Buprenorphine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=662)July 22, 2011Busulfan (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=754)July 12, 2011Butorphanol Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=771)August 02, 2011Caffeine/Caffeine and Sodium Benzoate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=352)July 22, 2011Calcitriol Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=776)July 27, 2011Calcium Chloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=657)August 02, 2011Calcium Gluconate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=48)July 22, 2011Capecitabine Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=758)August 04, 2011Capreomycin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=815)August 04, 2011Carboplatin Solution for Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=659)July 28, 2011Cefaclor Suspension (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=566)July 26, 2011Cefotetan Disodium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=521)July 26, 2011Cefpodoxime (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=793)July 29, 2011Choline Magnesium Trisalicylate (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=556)July 20, 2011Chorionic Gonadotropin (Human) Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=382)July 22, 2011Cilostazol Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=809)July 22, 2011Ciprofloxacin Immediate-Release Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=572)July 06, 2011Ciprofloxacin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=645)August 03, 2011Cisplatin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=57)June 23, 2011Clarithromycin Immediate-Release Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=726)July 29, 2011Clevidipine Butyrate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=620)July 18, 2011Cocaine Topical Solution (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=779)July 12, 2011Cyanocobalamin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=769)July 22, 2011Cytarabine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=413)August 03, 2011Dacarbazine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=653)August 03, 2011Daunorubicin Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=680)August 03, 2011Deferoxamine Mesylate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=655)June 30, 2011Denileukin Diftitox Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=807)July 12, 2011Desmopressin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=658)July 08, 2011Dexamethasone Sodium Phosphate (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=751)August 04, 2011Digoxin Immune Fab (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=389)June 10, 2011Digoxin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=748)July 29, 2011Diltiazem Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=217)August 03, 2011Dipyridamole Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=465)August 03, 2011Dopamine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=88)August 02, 2011Doxorubicin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=464)July 20, 2011Doxorubicin Liposomal Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=806)August 05, 2011Doxycycline Hyclate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=431)June 30, 2011Echothiophate Powder for Ophthalmic Solution (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=85)August 05, 2011Edrophonium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=739)July 27, 2011Epinephrine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=685)July 22, 2011Ethiodized Oil (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=618)June 07, 2011Etomidate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=419)August 03, 2011Etoposide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=652)August 01, 2011Famotidine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=810)August 04, 2011Fluconazole Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=644)August 04, 2011Fludarabine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=648)August 03, 2011Fluorouracil Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=798)July 28, 2011Fluphenazine Decanoate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=402)August 02, 2011Fluticasone Nasal Spray (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=628)July 12, 2011Foscarnet Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=693)July 20, 2011Fosphenytoin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=127)July 22, 2011Furosemide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=636)July 27, 2011Ganciclovir Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=539)July 27, 2011Gentamicin injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=728)August 04, 2011Glycopyrrolate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=385)July 22, 2011Gold Sodium Thiomalate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=725)August 02, 2011Granisetron Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=633)July 29, 2011Haloperidol Decanoate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=526)August 04, 2011Haloperidol Lactate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=527)June 17, 2011Heparin Sodium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=387)July 20, 2011Hepatitis A Virus Vaccine Inactivated (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=180)July 26, 2011Hepatitis B Vaccine Recombinant (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=520)August 01, 2011Hyaluronidase Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=580)June 17, 2011Hydralazine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=774)August 02, 2011Hydromorphone Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=524)June 03, 2011Hydroxocobalamin Injection (Cyanokit) (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=722)July 26, 2011Ibuprofen lysine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=669)July 27, 2011Idarubicin Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=650)August 03, 2011Indomethacin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=596)July 27, 2011Intravenous Fat Emulsion (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=651)July 14, 2011Irinotecan Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=772)August 03, 2011Iron Injections (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=780)July 15, 2011Kanamycin Sulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=522)June 08, 2011Ketorolac Tromethamine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=593)July 15, 2011L-Cysteine Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=632)July 14, 2011Labetalol Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=397)August 04, 2011Leflunomide Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=711)August 01, 2011Leucovorin Calcium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=488)August 03, 2011Leuprolide Acetate 14-Day Kit (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=737)July 22, 2011Levofloxacin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=812)August 03, 2011Levorphanol Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=622)July 27, 2011Lidocaine 2% Emergency Syringes (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=675)June 17, 2011Liotrix Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=24)July 26, 2011Lorazepam injectable presentations (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=747)July 06, 2011Magnesium Sulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=757)August 04, 2011Measles, Mumps, Rubella and Varicella Virus Vaccine Live Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=247)June 07, 2011Mechlorethamine Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=25)August 02, 2011Mesna Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=642)July 27, 2011Metaxalone Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=787)July 05, 2011Metformin Oral Solution (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=700)July 12, 2011Metformin Oral Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=731)July 27, 2011Methotrexate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=26)August 03, 2011Methoxsalen Capsules and Lotion (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=565)July 26, 2011Methylene Blue Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=27)July 22, 2011Methylphenidate Hydrochloride (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=752)August 03, 2011Methylprednisolone Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=759)July 08, 2011Metoclopramide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=611)July 22, 2011Metoprolol Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=813)July 29, 2011Metronidazole Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=643)July 05, 2011Metronidazole tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=716)July 26, 2011Mexiletine Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=581)June 10, 2011Midazolam 1 mg/mL Injections (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=676)August 04, 2011Milrinone Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=741)July 29, 2011Mitomycin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=433)August 04, 2011Morphine Injections (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=664)July 28, 2011Multiple Vitamins for Infusion - Adults (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=424)July 14, 2011Nalbuphine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=665)August 02, 2011Neostigmine Methylsulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=311)July 22, 2011Nicardipine Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=31)June 09, 2011Nitroglycerin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=786)July 26, 2011Norepinephrine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=712)August 03, 2011Octreotide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=803)July 21, 2011Ondansetron Injection 2 mg/mL (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=510)July 29, 2011Oseltamivir Phosphate Oral Suspension (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=717)July 13, 2011Oxycodone Immediate Release Tablets and Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=509)July 12, 2011Oxycodone Immediate Release Solution (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=678)July 22, 2011Paclitaxel Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=790)August 05, 2011Papaverine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=781)July 22, 2011Paregoric Liquid (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=682)July 01, 2011Pentosan Polysulfate Sodium (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=799)June 28, 2011Pentoxifylline Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=606)June 17, 2011Phentolamine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=349)August 03, 2011Phenylephrine Hydrocholoride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=184)August 05, 2011Phenytoin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=740)July 20, 2011Phenytoin Oral (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=792)July 20, 2011Potassium Acetate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=668)July 27, 2011Potassium Phosphate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=709)August 01, 2011Prochlorperazine Edisylate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=796)August 03, 2011Promethazine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=654)July 15, 2011Propofol Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=573)July 19, 2011Protamine Sulfate (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=38)July 28, 2011Rabies Immune Globulin (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=331)July 13, 2011Reteplase Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=569)August 02, 2011Rifampin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=350)July 08, 2011Rocuronium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=434)July 13, 2011Rotigotine Transdermal Systems Patch (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=395)August 02, 2011Selenium Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=784)July 22, 2011Sodium Acetate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=762)August 04, 2011Sodium Bicarbonate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=788)July 26, 2011Sodium Chloride Concentrated Solution for Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=724)July 28, 2011Sodium Fluoride Oral Drops (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=694)July 13, 2011Sodium Phosphate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=770)July 22, 2011Sodium Thiosulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=766)July 22, 2011Streptozocin For Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=646)June 30, 2011Sucralfate Oral Presentations (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=773)July 26, 2011Sulfamethoxazole/Trimethoprim Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=613)July 26, 2011Terbutaline Sulfate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=808)July 28, 2011Testosterone Cypionate Intramuscular Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=638)July 27, 2011Thiotepa Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=589)July 28, 2011Thiothixene Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=667)July 05, 2011Thyrotropin Alfa (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=699)July 18, 2011Ticarcillin Clavulanate (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=802)July 12, 2011Ticlopidine Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=661)June 24, 2011Tobramycin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=701)July 28, 2011Topiramate Capsules (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=765)July 26, 2011Torsemide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=344)July 22, 2011Trace Elements Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=785)July 22, 2011Trazodone Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=681)July 06, 2011Triamterene and Hydrochlorothiazide Capsules and Tablets (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=755)August 03, 2011Valproate Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=768)July 20, 2011Vancomycin Hydrochloride Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=132)July 13, 2011Vasopressin Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=795)July 26, 2011Vecuronium Bromide Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=490)July 28, 2011Vincristine Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=42)June 28, 2011Vitamin A Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=704)June 23, 2011Zinc Injection (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=777)July 22, 2011Zoster Vaccine Live (http://www.ashp.org/DrugShortages/Current/Bulletin.aspx?id=422)July 26, 2011

[sarah]

could this be the problem:
Shortchanging Cancer Patients

By EZEKIEL J. EMANUEL

Ezekiel J. Emanuel is an oncologist and former White House adviser who will be a professor of medical ethics and health policy at the University of Pennsylvania beginning in September. He will be contributing regularly to Op-Ed.
RIGHT now cancer care is being rationed in the United States.
Probably to their great disappointment, President Obama’s critics cannot blame this rationing on death panels or health care reform. Rather, it is caused by a severe shortage of important cancer drugs.
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. As Dr. Michael Link, the president of the American Society of Clinical Oncology, recently told me, “If you are a pediatric oncologist, you know how to cure 70 to 80 percent of patients. But without these drugs you are out of business.”
This shortage is even inhibiting research studies that can lead to higher cure rates: enrollment of patients in many clinical trials has been delayed or stopped because the drugs that are in short supply make up the standard regimens to which new treatments are added or compared.
The sad fact is, there are plenty of newer brand-name cancer drugs that do not cure anyone, but just extend life for a few months, at costs of up to $90,000 per patient. Only the older but curative cancer drugs — drugs that can cost as little as $3 per dose — have become unavailable. Most of these drugs have no substitutes, but, crazy as it seems, in some cases these shortages are forcing doctors to use brand-name drugs at more than 100 times the cost.
Only about 10 percent of the shortages can be attributed to a lack of raw materials and essential ingredients to manufacture the drugs. Most shortages appear instead to be the consequence of corporate decisions to cease production, or interruptions in production caused by money or quality problems, which manufacturers do not appear to be in a rush to fix.
If the laws of supply and demand were working properly, a drug shortage would cause a price rise that would induce other manufacturers to fill the gap. But such laws do not really apply to cancer drugs.
The underlying reason for this is that cancer patients do not buy chemotherapy drugs from their local pharmacies the way they buy asthma inhalers or insulin. Instead, it is their oncologists who buy the drugs, administer them and then bill Medicare and insurance companies for the costs.
Historically, this “buy and bill” system was quite lucrative; drug companies charged Medicare and insurance companies inflated, essentially made-up “average wholesale prices.” The Medicare Prescription Drug, Improvement and Modernization Act of 2003, signed by President George W. Bush, put an end to this arrangement. It required Medicare to pay the physicians who prescribed the drugs based on a drug’s actual average selling price, plus 6 percent for handling. And indirectly — because of the time it takes drug companies to compile actual sales data and the government to revise the average selling price — it restricted the price from increasing by more than 6 percent every six months.
The act had an unintended consequence. In the first two or three years after a cancer drug goes generic, its price can drop by as much as 90 percent as manufacturers compete for market share. But if a shortage develops, the drug’s price should be able to increase again to attract more manufacturers. Because the 2003 act effectively limits drug price increases, it prevents this from happening. The low profit margins mean that manufacturers face a hard choice: lose money producing a lifesaving drug or switch limited production capacity to a more lucrative drug.
The result is clear: in 2004 there were 58 new drug shortages, but by 2010 the number had steadily increased to 211. (These numbers include noncancer drugs as well. )
Unfortunately, there is no quick fix, because all solutions require legislation. A bill introduced in February by Senator Amy Klobuchar, Democrat of Minnesota, and Senator Bob Casey, Democrat of Pennsylvania, would require generic manufacturers to notify the Food and Drug Administration if they expected a supply problem or planned to stop manufacturing a drug. But the F.D.A. isn’t able to force manufacturers to produce a drug, and learning about impending shortages with little authority to alleviate them is of limited benefit. Indeed, early warning could exacerbate the problem: the moment oncologists or cancer centers hear there is going to be a shortage of a critical drug, their response could well be to start hoarding.
You don’t have to be a cynical capitalist to see that the long-term solution is to make the production of generic cancer drugs more profitable. Most of Europe, where brand-name drugs are cheaper than in the United States, while generics are slightly more expensive, has no shortage of these cancer drugs.
One solution would be to amend the 2003 act to increase the amount Medicare pays for generic cancer drugs to the average selling price plus, say, 30 percent, after the drugs have been generic for three years. This would encourage the initial rapid price drop that makes generics affordable, but would allow for an increase in price and profits to attract more generic producers and the fixing of any manufacturing problems that subsequently arose.
Increasing the price for generic oncology drugs would have a negligible impact on overall health care costs. Total spending on generic injectable cancer drugs was $400 million last year — just 2 percent of cancer drug costs, and less than 0.5 percent of the total cost of cancer care. If we are worried about costs, we could follow Europe and pay for the higher prices by lowering what Medicare pays for the brand-name drugs that extend life by only a few months.
A more radical approach would be to take Medicare out of the generic cancer drug business entirely. Once a drug becomes generic, Medicare should stop paying, and it should be covered by a private pharmacy plan. That way prices can better reflect the market, and market incentives can work to prevent shortages.
Scare-mongering about death panels and health care reform has diverted attention from real issues in our health care system. Shortages in curative cancer treatments are completely unacceptable. We need to stop the political demagoguery and fix the real rationing problem.

[hutchibk]

Thanks Sheila... it's a shame for this to be happening. Welcome to the future, unless corrections can be made swiftly.

As one who has a visceral distrust of Zeke Emanuel, here's what I have been reading about this:

The Disturbing Rise in Drug Shortages:

A “Multifactorial” Problem
June 10, 2011 by Kate Greenwood


With the Annual Meeting of the American Society of Clinical Oncology this past week came a wave of news stories about cancer and cancer treatment. Frank Pasquale highlights a disturbing warning issued by oncologists at the meeting, that “cancer medicines desperately needed by sick children and adults are in short supply, undermining the ability of U.S. doctors to administer treatments.” Supplies of other medicines are running short, too, including treatments for anaphylactic shock, attention deficit hyperactivity disorder, cardiac arrest, cystic fibrosis, and infertility.
Writing for the AP, Lauran Neergaard reports that “[t]he problem of scarce supplies or even completely unavailable medications isn’t a new one but it’s getting markedly worse.” According to Lancet Oncology, there were a record 211 drug shortages in 2011, up from 166 in 2009, 149 in 2008, 129 in 2007, and 70 in 2006. Neergard adds that “another 89 drug shortages have occurred in the first three months of this year[.]”
Most of the medicines that have run short are sterile injectable drugs, which are complex and time-consuming to manufacture. (The anesthesia drug sodium thiopental which I blogged about here falls into this category.) And, most, or even all, of the shortfall drugs are no longer subject to protection from a patent or Food & Drug Administration-administered exclusivity period, so the innovator firms that developed them are subject to competition from generic manufacturers. The resultant lower prices and slimmer profit margins mean that, in the words of leading oncologist Dr. Richard Schilsky, the manufacturers’ return on investment is “pretty low.”

Among the reasons cited for the rise in drug shortages are the inherent challenges of manufacturing sterile injectable drugs, the low return on investment facing generic manufacturers, which has led the number of manufacturers of any given generic drug to dwindle, drug company mergers, which can result in the discontinuation of one of two similar products, the time it takes the FDA to approve applications to make manufacturing changes, for example a change in the source of a drug’s active ingredient, and the failure of the FDA to act expeditiously in investigating manufacturing problems and clearing plants to resume production once the problems have been resolved.

The Preserving Access to Lifesaving Medications Act, introduced in February by Senators Robert Casey and Amy Klobuchar, would require manufacturers to notify FDA “of a discontinuance, interruption, or other adjustment of the manufacture of the drug that would likely result in a shortage of such drug[.]“ Per Lauran Neergard, the FDA “was able to prevent 38 close calls from turning into shortages last year by speeding approval of manufacturing changes or urging competing companies to get ready to meet a shortfall.” The FDA has even permitted (temporarily) the import of medicines approved outside the United States when necessary to mitigate shortages.

Participants in a Drug Shortages Summit convened late last year by the American Society of Clinical Oncology and others recommended that additional legislative and regulatory reforms be explored, ranging from providing incentives to manufacturers in exchange for a guarantee that they continue producing critical drugs, to charging manufacturers fees to fund expedited FDA review of applications for permission to manufacture generic drugs, to requiring manufacturing redundancies (e.g. that more than one source for a drug’s active ingredient be identified) as a condition of approval. Interestingly, while some participants in the Drug Shortages Summit argued that products liability exposure could cause companies to withdraw drugs from the market, the manufacturers who attended denied this, calling the decision “multifactorial.” There is evidence to support the manufacturers’ claim. As I discussed here, in late 2004, after Chiron Corporation announced that it would not be able to provide flu vaccine for the United States market that year due to manufacturing issues, Congress brought the flu vaccine into the Vaccine Injury Compensation Program fold. Unfortunately, liability relief did not result in an increase in the number of manufacturers in the flu vaccine market. Targeted reforms like those that the Summit participants recommend be explored seem more likely to be effective at ensuring a steady, reliable supply of vital medicines.