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For months, oncologists have warned that there is a serious shortage of the medications they need to treat their patients. The problem has gotten so bad that cancer care is being "rationed" in the US, says oncologist Ezekiel Emanuel in a New York Times opinion piece. Of the 34 generic cancer drugs on the market today, 14 are in short supply, Emanuel says, including drugs that are used to treat leukemia, lymphoma, and testicular cancer. "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," Emanuel says. "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." The problem isn't just a shortage of raw materials and ingredients needed to make the drugs, but rather is a "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," he adds. In addition, the Medicare Prescription Drug, Improvement and Modernization Act of 2003 signed into law by then-President George W. Bush requires Medicare to pay doctors who prescribe cancer medications based on the drug's actual price, and put a cap on how much the prices could increase — the consequences of this are that when a cancer drug goes generic and its price drops, a shortage won't re-inflate the prices because of the cap, leading companies to decide to produce more lucrative drugs instead of the cheaper life-saving drugs, Emanuel says.

HT: In the Pipeline's Derek Lowe

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