Caring for a Three Legged Dog or Cat
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Cheap, generic pharmaceuticals come with a high price these days as many critical, lifesaving drugs are becoming scare at human and veterinary hospitals around the U.S. Will your chemo drug be next?
Tripawds member Princeton brought the shortage to our attention recently so we asked one of our favorite oncologists, Dr. Johnny D. Chretin, DVM, DACVIM of VCA West Los Angeles Animal Hospital, if he could tell us more about chemotherapy drug shortages in the veterinary world.
"As far as drug shortages, its an epidemic. Bottom line is they are mostly generic, older drugs, that we are talking about. . . It all adds up to trouble. " says Dr. Chretin.
Chemotherapy drug shortages include carboplatin, doxorubicin, and cisplatin. This list on PetMD includes other important veterinary drugs in short supply, such as the antibiotic cipro.
Experts give many reasons for the shortages but currently there are few solutions and the problem is getting worse every year.
Industry Consolidations and Patent Expirations
As patents expire on many older drugs, ranging from pain relievers to life saving chemotherapy agents, manufacturer profits can drop by as much as 90 percent, leaving companies with less profit incentive to continue making these drugs. In addition, the pharmaceutical industry is constantly undergoing constant mergers and acquisitions, which causes a dearth of manufacturers available to produce costly but lifesaving drugs.
Despite the shortage, the usual laws of "supply and demand" don't apply here because the federal government prohibits manufacturers from raising prices on drugs more than six percent every six months.
To exacerbate the situation, companies are manufacturing their newer, patented chemotherapy drugs that are often the same drug as the older generic version but cost much more for patients. Unfortunately there are few alternatives for the older generic drugs that are in short supply and if a patient needs immediate treatment, their physician or veterinarian must turn to the newer, more expensive version. Sometimes they'll look for vendors selling the older drug in the "gray markets" where markup is astronomical and quality control can be an issue.
Medical providers are often caught off-guard when a shortage happens, mainly because the Federal Drug Administration doesn't require manufacturers to tell hospitals when their drugs will be in short supply. Currently, two bills in the federal government (Senate 296 and House 2245) have been proposed to require manufacturers to provide notice. Contact your representative to support these bills!
Be Prepared, Stock Up
To avoid being caught without the drugs your Tripawd (or you) need, do what Princeton's mom did, and order enough ahead of time to cover all necessary treatments. While this will hurt your pocket book, at least you won't go without.
If you've run into a drug shortage, what did you do to handle the situation? Let us know below in the Comments section, we'd love to know.
22 August 2008
We do sometimes encounter drug shortages even with common drugs like cephalexin (antibiotic). We can usually get around this by ordering from another distributor, using human pharmacies, or veterinary compounding pharmacies (I like Diamondback Drugs). As far as chemo goes it can be challenging so it is often best to check drug supplies before selecting chemo agents. The one drug that goes on backorder most often is called l-asparaginase (Elspar) but that is most commonly used to treat lymphoma.
I realize that this is not a typical *drug* that you order at a pharmacy, but I know there is a shortage of Immiticide for heartworm treatments, especially here in Florida. My little foster monkeybutt Farley is doing a month of Doxycycyline and then back to back injections....thank God we were able to secure some.
And if I were more computer literate, I'd post a pic but as Jerry and others know.....I'm not.