New York Times: Supply of Methotrexate May Run Out Within Weeks

RA Guy Community News 7 Comments

“This is dire,” said Valerie Jensen, associate director of the Food and Drug Administration’s drug shortages program. “Supplies are just not meeting demand.”

The drug is methotrexate, and the cancer it treats is known as acute lymphoblastic leukemia, or A.L.L., which most often strikes children ages 2 to 5. It is an unusually virulent cancer of white blood cells that are overproduced in bone marrow and invade other parts of the body.

The cancer commonly spreads to the lining of the spine and brain, and oncologists prevent this by injecting large quantities of preservative-free methotrexate directly into the spinal fluid. The preservative can cause paralysis when injected into the spinal column, so cannot be used for this disease. Methotrexate is also used to treat rheumatoid arthritis.

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Comments 7

  1. Linda P.

    Wow. Methotrexate didn’t work for me, so I’m no longer on it, but I hope this issue is soon resolved on the behalf of those with RAD and childhood and other cancers who need the medication.

  2. abcsofra

    My heart goes out to those on metho. The article wouldn’t load for me so I am not sure why the short supply but I remember going through this with Enbrel (I was in the newer days of Enbrel) and it was a stressful time for me wondering if and when I might be able to get my “fix”. Having lots of business background I don’t understand the supply problem unless there is a contamination issue going on. Thank you for always keeping us up to the moment with things that impact our lives.

  3. Terry

    I do take MTX however, I am not letting this bother me. Stress acts as a trigger for RA and, for me, can bring on more pain and fatigue. I refuse to let this have that much control over my life. If I have to find a different med, I will.

  4. Matt Chappuies

    This is a huge problem for children suffering from Acute Lymphoblastic Leukemia. Methotrexate is one of the staple chemotherapy drugs taken by leukemia patients. My six year old daughter suffers from A.L.L. and her prognosis for survival would be decreased by 20 % if methotrexate was not part of her treatment protocol. This would be a severe setback for all present and future leukemia patients. I intend on being very proactive regarding this matter.

  5. Joie

    First of all, to clarify any misunderstanding from the photo of mtx pills – the shortage is for injectable mtx.

    I’ve had trouble getting injectable mtx since the fall of last year. My mail order pharmacy was out, as well as two nearby CVS pharmacies. Fortunately, I found a CVS pharmacy in another town that still had the 2ml vials I use in stock – that is until recently. Last month, they ran out.

    I take inj mtx rather than mtx pills, cuz after decades of taking NSAIDS for RA, I developed GERD and an ulcer, so switching back to mtx pills is not an option for me. While going w/out mtx may cause the RA to flare, it is not a life and death situation for me, as it is for kids with A.L.L, a particular type of leukemia, that when treated with preservative free inj mtx is curable in 90% of cases.

    My understanding is that the shortage is due in part because inj mtx, a generic sterile injectable, is not profitable to make, so there are few manufacturers. When one drug company decides to stop making inj mtx or when a drug manufacturer has to stop production because of quality issues or make equipment repairs, the remaining companies cannot keep up w/the demand.

    According to a report in the NEJM, another reason is because oncologists rely on drug sales for half their revenue, prescribing expensive drugs instead of cheap ones. “With doctors writing prescriptions for brand-name drugs instead of their generic equivalents, demand for generics plummeted. So companies stopped making them.”(1)

    This isn’t the first time there’s been a shortage. From a July 19, 2005 article:

    “Doctors across the country are concerned about a shortage of some key drugs used to treat pediatric cancer.

    Children’s cancer drugs like methotrexate… are in short supply. This drug can also treat autoimmune diseases…

    In the past few years, pharmacists and physicians have scrambled to find at least five standard chemotherapy drugs at one time or other, says Mary Relling, pharmaceutical department chair at St. Jude Children’s Research Hospital in Memphis. …

    Doctors periodically grapple with shortages of many kinds of drugs, from painkillers to antibiotics. The drug methotrexate, used in pediatric cancer as well as some adult autoimmune diseases, also has been in short supply.”(2)

    So, the last shortage of inj mtx was in 2005 – seven years ago – and here we are again. So what will be done to prevent this from occurring again?

    Oh and for anyone trying to blame the shortage on “Obamacare,” not only was he not President in 2005, but the Affordable Care Act doesn’t go into effect until 2014.



  6. Susan Leder

    I have RA and asthma.I cannot take metotrexate pills due to stomach issues.Can we get this medication from another country?

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