http://www.arthritistoday.org/news/methotrexate-shortage180.php

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.

(1) http://articles.latimes.com/2011/nov/02/news/la-heb-cancer-drug-shortage-20111102

(2) http://www.usatoday.com/news/health/2005-07-19-cancer-drugs_x.htm