Nationwide Drug Shortages Hit WAY Too Close To Home: The Curious Case of Vincristine

Roughly a year ago, media outlets began covering the news of widespread chemotherapy drug shortages in the United States. At least one of driving interests in this news was the fact that these shortages are disproportionately impacting children and women. One of these drugs, vincristine (a.k.a. oncovin), is among the most frequently short-supplied chemotherapy agents, and is used prolifically in the treatment of leukemia and other blood-related cancers. You think about this and, certainly, anyone with a pulse would be moved to empathy, but probably in a quite disconnected way. You just don't realize how important a regular supply of these drugs is until, like the situation I found myself in during my third round of treatment, the pharmacist informs you that one of your life-saving drugs is not available. Of the four days I was in treatment, they had on hand enough vincristine for two days.

Of course I've explained that I'm a social statistician, so immediately my mind went to thoughts of whether the regimen would be effective with vincristine administered only half the time. Miraculously, and due in no small part to the vigilance and dedication of my healthcare team, they were able to locate enough vincristine for me to receive it the whole time. And you would think I'd be happy, but in fact, I was quite disturbed by this. It's all basic economics: if I get a drug in short supply, then someone else who also needs it is probably not going to get it. This is a cruel and utterly avoidable dilemma that oncology finds itself in, here in the United States.

Additionally, the public's understanding of this crisis is quite complicated. The Institute for Safe Medication Practices, for example, has extensively researched this issue and has found that despite the fact that shortages impact as many as 1-in-4 of all cancer patients, that most people fundamentally don't understand the reasons why drug shortages occur. A fantastic article in the New England Journal of Medicine, however, elucidated the issue quite directly: it's all about money. Vincristine, for example, is made from a simple flower, so there is no real medical reason as to why it should be in short supply. Simply put, drug companies have difficulty making the profit margins they would like off of drugs that are essentially naturally-occurring compounds; so... what they do, in effect, is stop making them from time to time so they can drive up the cost of the available supply. For all the sacrosanctness of "American exceptionalism," which by the way I largely agree with, it's just plain disgusting that we value profits over peoples' lives in something as literally life-or-death as cancer treatment.

It's difficult to say what can be done about this, especially given the enormous power of BigPharma; but change, as it were, has almost always occurred at the grassroots level. Some believe, as I think is a valid analysis, that the plain reality that people are dying so a few companies can make a buck will eventually catalyze a healthcare-centered solution to this problem. I certainly hope so, because most attempts to deal with this issue, to date, have been unsuccessful. The free market is a wonderful thing, and it has certainly driven the American economy to great riches; it also has NO place involving itself in decisions about whether or not people live. Please support organizations like Stop Drug Shortages so we can put an end to this atrocity now.