JOHN: ONE OF THE HALLMARKS OF THE PANDEMIC HAS BEEN SHORTAGES OF MANY ESSENTIAL PRODUCTS, EVERYTHING FROM DIAPERS TO BUILDING MATERIALS TO MEDICINE.

ONE RECENT SHORTAGE HAS LIMITED THE SUPPLY OF TWO CRITICAL CANCER DRUGS.

>> HOSPITALS AND CANCER CENTERS ARE RUNNING OUT OF TWO MAJOR INJECTABLE CANCER DRUGS.

A NEW SURVEY OF CANCER CENTERS NATIONWIDE FOUND 93% WERE EXPERIENCING A SHORTAGE OF THE DRUG AND 70% SHORTAGE OF THE OTHER.

EARLIER THIS WEEK BEFORE A HOUSE SUBCOMMITTEE, THE AMERICAN SOCIETY URGED THE FEDERAL GOVERNMENT TO TAKE ACTION TO STRENGTHEN THE DRUG SUPPLY CHAIN.

>> SHORTAGES PLACE PROVIDERS IN A MORAL DILEMMA, PRIORITIZING DRUGS FOR THOSE CURABLE VERSUS THOSE WHO ARE NOT.

PATIENTS WORRY ABOUT WHETHER THEY WILL RECEIVE THEIR NEXT TREATMENT OR IF SWITCHING TO ANOTHER WILL SHORTEN THEIR LIVES.

>> JOINING ME IS THE HEAD OF BREAST MEDICAL ONCOLOGY IN NEW JERSEY.

THANK YOU FOR JOINING US.

TELL US ABOUT HOW CRITICAL THESE DRUGS ARE.

WHAT SORT OF CANCERS ARE THEY USED TO TREAT?

>> THANK YOU FOR HAVING ME.

WE USE THEM FOR A VARIETY OF CANCERS IN BREAST AND GYNECOLOGICAL CANCERS, MY AREA OF EXPERTISE.

WE USE THEM FOR THE MAJORITY OF CASES OF ALL OF OUR GYNECOLOGICAL CANCER PATIENTS AND A LARGE PROPORTION OF BREAST CANCER PATIENTS AS WELL.

BUT THEY ARE USED FOR OTHER CANCER TYPES SUCH AS LUNG CANCER, TESTICULAR CANCER, AND GASTROINTESTINAL CANCERS, JUST TO NAME A FEW.

>> WHEN DID YOU START EXPERIENCING SHORTAGES?

>> SEVERAL WEEKS AGO, JUST LIKE ALL HOSPITALS THROUGHOUT THE COUNTRY.

>> HOW DOES THAT CHANGE THE ACCESS YOU AND YOUR COLLEAGUES HAVE TO THE DRUGS?

>> IT IS CHALLENGING AS AN ONCOLOGIST.

TALKING ABOUT SHORTAGES WITH PATIENTS WHEN THEY ARE ALREADY FACING A LIFE-CHANGING DIAGNOSIS IS REALLY DIFFICULT.

SITTING IN FRONT OF A PATIENT FOR ME AND MY COLLEAGUES ACROSS COUNTRY AND TELLING THEM WE HAVE PROVEN DRUGS THAT CAN WORK BUT WE ARE NOT SURE WHEN AND IF THEY WILL BE ABLE TO RECEIVE THEM.

IT IS AN AGONIZING CONVERSATION FOR BOTH MYSELF AS AN ONCOLOGIST, FOR OTHER ONCOLOGISTS, AND FOR THE PATIENT AND THEIR FAMILY.

>> ABSOLUTELY.

TELL ME ABOUT HOW IRREPLACEABLE THESE TWO DRUGS ARE.

IS IT EASY TO COME UP WITH SUBSTITUTES THAT DO THE SAME THING IN SOME OF THESE TREATMENTS?

>> IT IS NOT THAT EASY.

IT IS NOT AS SIMPLE AS SWITCHING ONE DRUG FOR ANOTHER.

IN CERTAIN CASES, THERE ARE SUBSTITUTIONS.

BUT WE HAVE TO KEEP IN MIND WHEN YOU SUBSTITUTE FOR ANOTHER DRUG, THERE ARE OTHER SIDE EFFECTS.

WE MAY BE VENTURING INTO LESS CHARTERED TERRITORY IN TERMS OF THE EVIDENCE THAT EXISTS.

IT IS NOT AS SIMPLE AS SAYING WE DON'T HAVE THESE, LET'S USE A DIFFERENT DRUG.

>> I WANT TO ASK YOU AS A DOCTOR AND HUMAN BEING, WHAT HAS THAT BEEN LIKE FOR YOU?

>> IT IS REALLY MORALLY CHALLENGING.

I THINK IT IS SOMETHING WE NEED TO TALK ABOUT.

TO BE ABLE TO HAVE TO MAKE DECISIONS ABOUT WHICH PATIENTS TO TREAT AND WHICH ONES TO POSTPONE, HOW TO TRY TO MAKE THE DRUGS LAST LONGER, IS SOMETHING ALL ONCOLOGISTS ARE GRAPPLING WITH RIGHT NOW.

IT REALLY IS UNPRECEDENTED FOR US.

THESE SHORTAGES ARE NOTHING I HAVE EVER SEEN IN MY CAREER.

MANY OTHER ONCOLOGISTS SAY THE SAME.

>> WHAT IS YOUR UNDERSTANDING OF WHY THESE SHORTAGES ARE AFFECTING THESE DRUGS IN PARTICULAR?

>> I THINK THERE ARE A NUMBER OF FACTORS.

A LOT OF IT DOES COME DOWN TO SUPPLY AND DEMAND.

WE HAVE SEEN A NUMBER OF THESE ISSUES SINCE THE PANDEMIC.

A LOT OF IT HAS TO DO WITH MANUFACTURING AND AVAILABILITY.

WE DO NEED A BIT MORE TRANSPARENCY IN TERMS OF HOW WE ASSESS AND ARE MADE AWARE OF DRUG AVAILABILITY.

>> THAT IS WHAT I WANTED TO ASK YOU ABOUT NEXT, THE TRANSPARENCY ELEMENT.

THERE ARE A LOT OF DIFFERENT ELEMENTS INVOLVED.

YOU HAVE THE PHARMACEUTICAL COMPANIES, MANUFACTURERS WHERE THE INGREDIENTS ARE SOURCED, THE FDA.

I'M CURIOUS AS A PRACTITIONER, WHAT SORT OF TRANSPARENCY OR LACK THEREOF HAVE YOU BEEN EXPERIENCING FROM THE VARIOUS ENTITIES?

>> I THINK IT IS HARD TO FIGURE OUT EXACTLY WHAT IS GOING ON.

AT THE BEGINNING OF THE SHORTAGES, WE DID NOT KNOW.

WE WERE NOT MADE AWARE OF WHY THE SHORTAGES WERE HAPPENING, WHEN THEY WOULD GET BETTER.

AS THE WEEKS HAVE GONE BY, THERE HAS BEEN MORE INFORMATION PROVIDED ABOUT WHERE THE DEMAND HAS INCREASED AND WHERE THE SUPPLY HAS BEEN LACKING.

BUT IT IS NOT ENTIRELY CLEAR WHEN WE WILL SEE THIS COME BACK TO FULL PRODUCTION AND FULL AVAILABILITY.

>> THE AMERICAN SOCIETY FOR CLINICAL ONCOLOGY HAS MADE SEVERAL RECOMMENDATIONS TO AVOID THESE SHORTAGES IN THE FUTURE.

THEY INCLUDE STRENGTHENING THE STRATEGIC NATIONAL STOCKPILE OF MEDICINE AND REDUCING RELIANCE ON OTHER COUNTRIES FOR SOME OF THESE IMPORTANT INGREDIENTS THAT GO INTO THE DRUGS.

WHAT CHANGES WOULD YOU LIKE TO SEE?

>> I AGREE WITH THOSE RECOMMENDATIONS.

I FEEL WE NEED TO HAVE BOTH SHORT-TERM SOLUTIONS FOR THE CURRENT SHORTAGE BUT LONG-TERM SOLUTIONS.

RIGHT NOW, IT IS THESE TWO.

IN A FEW MONTHS, IT COULD BE DIFFERENT DRUGS.

WE NEED TO HAVE A PLAN THAT ALLOWS US TO FACE IT SHORTAGE AND HOPEFULLY PREVENT IT FROM HAPPENING BUT IF IT IS THERE TO ACT QUICKLY AND PROBABLY TO GET THE DRUGS TO THE PATIENTS WHO NEED THEM.

THAT COULD MEAN HAVING A SUPPLY, THAT COULD MEAN INCREASING IMMEDIATE PRODUCTION IF NEEDED.

THERE ARE A NUMBER OF KEY STAKEHOLDERS INVOLVED.

>> THANK YOU SO MUCH FOR YOUR TIME.