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Letters to the Editor  |   March 2012
Support Legislation to Address Shortage of Chemotherapy Drugs
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Medical Education / Professional Issues
Letters to the Editor   |   March 2012
Support Legislation to Address Shortage of Chemotherapy Drugs
The Journal of the American Osteopathic Association, March 2012, Vol. 112, 112. doi:10.7556/jaoa.2012.112.3.112
The Journal of the American Osteopathic Association, March 2012, Vol. 112, 112. doi:10.7556/jaoa.2012.112.3.112
To the Editor: 
Recent prospective articles have outlined the main economic forces behind the growing shortage of generic chemotherapy drugs.1,2 However, the articles fail to highlight the unintended consequences that these drug shortages are having on routine patient care and medical education. 
We recently cared for a 38-year-old Haitian man who presented at our facility with AIDS and systemic Kaposi sarcoma with pulmonary involvement. Because of the national shortage of generic doxorubicin, the patient was unable to receive first-line treatment and was placed on the allocation list created by the pharmaceutical company. The patient instead was treated with paclitaxel, an inferior, more toxic, and typically more expensive form of chemotherapy.3,4 Therefore, as a direct result of the current drug-shortage crisis, the patient experienced a clinically significant delay in treatment, potentially leading to more medical complications and a more expensive hospital stay. Shortages of life-saving medications, such as doxorubicin, are unprecedented and are having a huge adverse impact on our ability to care for patients in our community. 
If you would like to have your voice heard regarding this serious problem, we urge you to contact your Congressional representatives and ask them to support the Preserving Access to Life-Saving Medications Act of 2011 (HR 2245). This bill, currently in the early stages of the Congressional legislative process, would amend the Federal Food, Drug, and Cosmetic Act to provide the Food and Drug Administration with improved capacity to prevent drug shortages.5 
References
Gatesman M, Smith TJ. The shortage of essential chemotherapy drugs in the United States [published correction appears in N Engl J Med. 2011;365 (25):2441]. N Engl J Med. 2011;365(18):1653-1655. [CrossRef] [PubMed]
Mitka M. FDA, US hospital and pharmacy groups report drug shortages a growing problem. JAMA. 2011;306(10):1069-1070. [CrossRef] [PubMed]
Northfelt DW, Dezube BJ, Thommes JAet al. Pegylated-liposomal doxorubicin versus doxorubicin, bleomycin, and vincristine in the treatment of AIDS-related Kaposi's sarcoma: results of a randomized phase III clinical trial. J Clin Oncol. 1998;16 (7):2445-2451. [PubMed]
Gill PS, Tulpule A, Espina BMet al. Paclitaxel is safe and effective in the treatment of advanced AIDS-related Kaposi's sarcoma. J Clin Oncol. 1999;17 (6):1876-1883. [PubMed]
HR 2245: Preserving Access to Life-Saving Medications Act of 2011. GovTrack.us Web site. http://www.govtrack.us/congress/bill.xpd?bill=h112-2245. Accessed February 6, 2012.