By: Marina Han

The generic industry’s supply of cheap drugs, which are used to treat cancer patients, is significantly decreasing, which will have a huge influence on patients.

In November, The U.S. Food and Drug Administration (FDA) inspectors arrived at the Intas Pharmaceuticals plant in India and quickly found trash bags stuffed with shredded documents. The inspectors analyzed the documents and realized that it was an attempt to hide quality problems at the plant. But the big problem is… this plant provided cisplatin and carboplatin for the U.S., which are both cheap generics to help cure many cancer patients. Cisplatin and carboplatin are not the only types of drugs with a lower supply – 12 other cancer drugs, disorder pills, blood thinners and antibiotics are all facing supply shortages. Now, cancer patients all over the U.S. are being forced into rationing plans for many different types of cancers. This can lead to deaths that could have been prevented.

The reason for all of this? Well, some factors are supply chain problems starting from the Covid-19 crisis and the FDA’s limited oversight, which means that the FDA does not have the capacity to fully supervise the supply chain . That is not good because without the FDA’s oversight, a production line can practically do anything they want. Because cisplatin and carboplatin are produced in special production lines, the FDA has to oversee them. Now, there is more production overseas, therefore the FDA cannot easily track them. A 2022 report has shown that the FDA inspects only 3% of the production sites in India that make drugs for the U.S. ,b ut the main reason is the terrifying weakness of the generic industry. Apparently, the drugs like cisplatin and carboplatin are usually sold for very little, which means the sellers get an extremely low profit, y. Domestic manufacturers instead want to sell high-priced drugs so they can earn more money because brand-name cancer drugs can cost tens of thousands of dollars annually.

Although this issue has been going on for a while already, it still infuriates many clinicians. While drugmakers are focused on creating drugs that cost a ton of money, doctors are stressed about the thousands of patients that are not even able to receive a $6 drug like cisplatin.

One doctor who is concerned about this problem is Dr. Mark Ratain, a cancer doctor and pharmacologist at the University of Chicago. “It’s just insane,” he said to a Los Angeles Times journalist. “Your roof is caving in, but you want to build a basketball court in the backyard because your wife is pregnant with twin boys and you want them to be NBA stars when they grow up?” In other words, doctors are struggling to find more drugs that are quite cheap. Meanwhile, some manufacturers just want to earn more money by selling high-priced drugs. They are trying to make a high-cost unnecessary addition but ignoring the necessary problem that would be much cheaper to resolve.

Dr. Stephen Divers, an oncologist in Arkansas, is also worried. In recent weeks, he had to change treatments for multiple cancer patients because of the shortage of cisplatin and carboplatin. “It’s just a travesty that this is the level of health care in the United States of America right now,” he reported to a Los Angeles Times journalist. Many people had set their level of expectations high for America’s health care but the U.S. seems to be letting them down.

One cancer patient influenced by the shortage of cancer drugs is Isabella McDonald, who was diagnosed with a rare and fatal cancer just earlier this year. Her father, Brent, said that they got notified that Isabella would get less than a full dose of methotrexate due to a shortage.

“They don’t think it will have a negative impact on her treatment, but as far as I am aware, there isn’t any scientific basis to make that conclusion,” he explained to a Los Angeles Times journalist. “As you can imagine, when they gave us such low odds of her beating this cancer, it feels like we want to give it everything we can and not something short of the standard.” Hopefully, Isabella will win her battle fighting cancer. It is unfair that cancer patients like her have to live through hardships just because manufacturers want to make more money.

It is extremely unsafe for cancer patients to receive only a portion of a whole dose of medicine but doctors have no choice. Dr. Bonny Moore, an oncologist in Virginia, shared to a Los Angeles Times journalist that in May, the clinicians at her practice gave some uterine cancer patients only 60% of a dose of carboplatin. The percentage shifted to 80% after a shipment in the following week and 10 days later, things had not changed. An entire dose could significantly help patients but just ⅗ or ⅘ of a dose will not help as much.

The generic industry is not only producing less cheap and essential cancer drugs, but some generic manufacturers are even going out of business. Akorn, a pharmaceuticals manufacturer that made 75 common generics, went bankrupt and closed in February.

Although cisplatin, carboplatin and other drugs were said to be cheap, their prices have now suddenly skyrocketed. Richard Scanlon, a pharmacist at Moore’s clinic, stated to a Los Angeles Times journalist that a 600-milligram bottle of carboplatin used to cost $30 but was going for $345 in May. It may be because of the shortage of carboplatin. So now, not only do doctors struggle with finding more drugs, but they also have to pay a huge amount for them. Alan Coukell, the senior vice president for public policy at Civica Rx, a generic drug company, shared to a Los Angeles Times journalist, “At a certain point the system needs to recognize there’s a high cost to low-cost drugs.” And it is true; low-cost drugs, no matter how great they seem, still cause problems.

Hopefully, the generic industry can quickly find a solution to the shortage of cancer drugs. Meanwhile, many cancer patients are struggling under the influence of not having enough genetics to keep them alive and doctors are scrambling to find more. People all over the U.S. are deeply disappointed about their country’s horrible healthcare system. Making more money is not as important as saving someone’s life.