Fargo cancer centers work to manage med supplies

FARGO — As supplies of cancer treatment drugs continue to dwindle nationwide, both of the area’s major health care providers are working to manage inventory and shuffle procedures to insulate patients from the worst effects of the shortage.

Over the past few months, a combination of manufacturing problems, raw material supply snags and regulatory issues have squeezed production on a number of drugs — mostly injectable ones — used to treat diseases ranging from leukemia to lymphoma to breast cancer.

Mark Plencner, supervisor for the pharmacy at Sanford’s Roger Maris Cancer Center in Fargo, said even though the center has managed to stave off dire steps for now, it’s still feeling the pinch.

“We’re in the thick of it just like everybody else,” he said.

Like other health care providers, the center has handled the shortages in part by stocking up on key drugs to safeguard against scarcity. When supply was not an issue, Plencner would keep a week’s supply of drugs on the shelf. Now, he’s had to stock up to make sure patients have what they need.

He said that strategy isn’t ideal because it ultimately exacerbates the problem.

“Fear within centers leads to stockpiling, and that takes product out of the pipeline,” Plencner said. “That’s really not where we want to be.”

He said the current shortages are among the more acute he’s seen in his 15 years with the center. The center now has a drug shortage committee that meets to analyze supply issues as they arise.

In some situations, the center can procure a drug from another Sanford hospital, or refer patients elsewhere — though in the event of widespread shortages, those strategies only go so far.

Thus far, the effects of the current shortage on Sanford patients have been limited to some dose delays “by a day or two,” Plencner said.

“We haven’t, to my knowledge, had to change to a different regimen at this point,” he said. “I can’t say that won’t happen.”

At Essentia Health’s Cancer Center, meanwhile, Dr. Sanjay Vinjamaram, an oncologist, said he’s had to do some shuffling and prioritizing to keep treatments rolling. He plans treatments carefully based on what’s available — these days, that’s a moving target week to week, and sometimes day to day — and finds alternate drugs when possible.

The hospital is filing paperwork with drug companies to get certain patients on waiting lists for single doses of critical treatments. They’ve had success so far, though there’s no guarantee they’ll get the drugs.

“So far, I have not had any delays in treatment or discontinuations of treatment, thankfully,” Vinjamaram said.

He said the majority of shortages he’s seen are in generic drugs that don’t produce high profit margins for pharmaceutical companies — a factor some suspect has contributed to slower production of those drugs.

He’s not thrilled to have to tinker with treatments or use replacement drugs.

“When you’re trying to use an alternate drug, there’s always a question, ‘Is it really going to be as effective as the drug you intended to use?’” Vinjamaram said. “In most situations, it is all right. In some situations, it’s not all right.”

Patients are likewise concerned, he said, and often baffled that life-saving drugs can be in short supply.

“We’ve discussed the reality of what’s going on,” he said. “After you discuss (it) with them, most are comfortable. But there’s still that nervous uneasiness. When you say you intend to do a drug and it’s not available, it’s certainly unsettling for everyone.”

Marino Eccher is a reporter at The Forum of Fargo-Moorhead, which is owned by Forum Communications Co.

Tags: news, medical, cancer, health