Doctors and pharmacists in central Nebraska are beginning to worry about a decreasing supply of the chemotherapy drugs cancer patients need most.
It's a problem experts in oncology say is based on economics.
"Generics aren't as profitable as what the newest brand name drugs are and so the drug manufacturers have to say, do we want to spend all of our time manufacturing drugs that aren't as profitable, or do they spend their time using those manufacturing facilities for drugs that are very profitable," Saint Francis Medical Center Pharmacy Supervisor Angie Obermiller says.
That makes those basic, generic chemotherapy drugs the hardest to keep in stock.
"It's those workhorses, it's the generic products that have been out for years that really do the main part of chemotherapy for curable cancers," Obermiller says.
But Saint Francis Medical Director of Oncology Dr. Mehmet Sitki Copur says alternate brands or dosages of those hard-to-find generics don't always have the same results.
"When you are missing one drug or there is shortage of one or two drugs, it ends up affecting the delivery of optimum combination," Copur says.
At the Saint Francis Cancer Treatment Center, the effects haven't trickled down to the patients just yet.
"I have been lucky with my team here, that we have a very dedicated Pharmacy Oncology Department," Copur says. "They have anticipated the shortages and always kept us with enough supplies for patients."
But that's not the case at other treatment centers across the country, and eventually could become an issue for patients in central Nebraska.
"It is more extreme now than it ever has been in the past," Obermiller says. "It's forecasting to get worse so we're really having to put the physicians in a position where they have to sometimes allocate themselves, prioritize their patients, of who's going to get what drug so we can serve the best population."
Obermiller says the people who suffer the most from the shortages are the patients. Health professionals are concerned because they don't anticipate a solution anytime soon.
Obermiller says bills in Congress and FDA efforts are trying to keep track of the shortages and work toward a solution.
"They are all working on a solution," Copur says. "But the problem is multi-factorial and a solution will not be soon and it will not be easy."