A number of chemotherapy drugs are in short supply in the US, and according to this opinion article in NEJM , the main reason for the shortage is economic. "If manufacturers don't make enough profit, they won't make generic drugs," like many of these chemotherapy agents and, further, oncologists don't have much of an incentive to prescribe generic drugs since they themselves buy and sell chemotherapy agents, write Mandy Gatesman and Thomas Smith. The authors add that "to ensure a predictable supply of generic cancer drugs, manufacturers need reasonable markets and profits, and oncologists need incentives to use generics."
Another opinion piece in NEJM discusses the recent draft report from the US Preventive Services Task Force that recommends against prostate specific antigen screening for prostate cancer. Fritz Schröder points out that the report is limited due to its reliance on meta-analyses that included high- and low-quality data. He instead says risk stratification is important and that "PSA screening should not be dismissed as uniformly non-beneficial. Rather, decisions about screening should be made on an individual basis, by an informed patient and his clinician, after weighing that patient's particular risk factors."