Vincristine Shortage – Update and Action To the Childhood Cancer Community

Editor’s Note: We do not have anyone in our family or friends (at the moment) who are personally affected by this shortage. However, we felt that this story in The New York Times on page A21 of our San Francisco printed version should have wider distribution. 

https://pubchem.ncbi.nlm.nih.gov/compound/Vincristine

October 16, 2019 

As Chair of the Children’s Oncology Group (COG), I am sending this letter to the childhood cancer community to share information we have related to the current vincristine drug shortage, summarize steps we understand are being taken to help resolve the shortage, and to propose an approach that would benefit from an advocacy effort to help address the ongoing challenge of drug shortages that directly impact children with cancer.

Vincristine Shortage

At the beginning of October, pharmacists at COG member institutions raised concerns about the ability to obtain vincristine. COG quickly contacted Pfizer/Hospira, now the sole supplier of vincristine in the United States, and was told that Pfizer/Hospira was experiencing a shortage of drug due to a manufacturing delay. (The other supplier of vincristine in the US, Teva Pharmaceuticals, made a “business decision” and stopped supplying drug to the US in July of 2019.) COG then contacted Captain Valerie Jensen, RPh, Associate Director of the Drug Shortages Staff at the FDA, to share this information. She reported that FDA had been contacted by Pfizer/Hospira, were exploring the drug shortage and had started working on potential solutions. An FDA update this morning stated that Pfizer/Hospira now expects vincristine distribution to resume by the end of October. We are hopeful that this distribution will help avert more patients not being able to receive drug as scheduled.

Members of the Children’s Oncology Group strongly believe that every child with cancer whose treatment requires vincristine should receive the drug as scheduled, and that a situation that requires rationing of drug is unacceptable. We and others have had longstanding concerns about the impact of drugs shortages for children with cancer, and believe that while legislation enacted in July of 2012 with Title X of the Food and Drug Administration Safety and Innovation Act (FDASIA) was helpful and important, it did not address key underlying factors that lead to shortages. We are greatly concerned that some children are already being impacted by this shortage and by the understandable anxiety this creates for all families of children with cancer. We have previously published guidelines to help physicians who may be forced to ration drug about approaches to consider, along with steps hospitals can take to minimize the impact of a drug shortage. To emphasize again, we find the situation forced upon pediatric oncologists and families of children with cancer unacceptable (see call to action below) but welcome the news that drug distribution should be resuming soon.