Oncologist: U.S. may need drug czar to stem shortages

Oncology is perhaps the greatest victim of drug shortages. And one insider is now rallying for a change to a system that leaves him unable to properly treat patients. The U.S. may need a "drug czar," says Gerald Segal of Northwest Cancer Specialists in Portland, OR. "Somebody's got to grab this situation and do something about it." 

Segal tells The Oregonian he has had to give patients reduced doses of the cancer drug leucovorin. But even more disturbing to him is that drug-shortage alarms have been sounded but no one sees a way out. 

Congressional bills aimed at relieving some drug-shortage pressure by requiring drugmakers to notify the FDA when a shortage is imminent, thereby providing some time to seek alternatives, appear to be struggling. Some legislators say the bills fall short of getting to the root of the problem.

That may be true. But at the rate that Congress moves, it's easy to see why Segal is calling for a drug czar.

Hospitals sometimes opt to buy from third-party suppliers, whose drugs may have unclear origins and questionable quality. Their alternative is withholding treatment. And sometimes doctors make the difficult choice to ration. One doctor says his group has rationed leucovorin this way: colon cancer patients considered curable receive full doses; patients considered terminal receive a partial dose. 

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