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Chronic Shortages Of Children’s Cancer Drugs Force US Hospitals To Work Together

Chronic Shortages Of Children’s Cancer Drugs Force US Hospitals To Work Together

The COVID pandemic has placed heavier strains on the American health-care system unlike any public health crisis seen since the Spanish flu 100 years ago. Hospit

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Chronic Shortages Of Children's Cancer Drugs Force US Hospitals To Work Together

The COVID pandemic has placed heavier strains on the American health-care system unlike any public health crisis seen since the Spanish flu 100 years ago. Hospital budgets have been strained after being forced to halt, or dramatically reduce, the number of elective surgeries, the biggest moneymakers for hospital budgets. While medical bills threaten to bankrupt thousands of individual Americans - some have suggested COVID-related medical bills could create a financial crisis as hospitals, paradoxically, face the threat of bankruptcy at a time when they are most badly needed.

It might seem hard to believe that hospitals could still be in such bad shape - financially speaking - after all the stimulus giveaways, including the $1.9 trillion stimulus package that will miraculously cut poverty in the US for 40% (for one year, until the flood of stimmies and benefits runs out, and the CDC is forced to lift its eviction moratorium). And as financial stresses lead to very real cutbacks in resources for patients, it looks like childhood cancer patients are being adversely effected in a way that could threaten the lives of many, as shortages of rare children's cancer drugs create new obstacles to treatment.

This is why, as Bloomberg reported Sunday, a group of hospital systems from around the country have turned to a Richmond-based company called Phlow Inc. that was initially financed by the Trump Administration. But now that the need for COVID treatments is subsiding, Eric Edwards, the company’s co-founder and chief executive officer, tells Bloomberg that the facility is about to pivot to making rare children's cancer drugs, many of which are simply reformulations of more common adult cancer drugs, in an effort to fix one of the biggest problem's plaguing children's cancer treatment in the US.

To accomplish this, Phlow is partnering with the Children’s Hospital Coalition, a group created by a network of independent US hospital systems with the goal of working together to end shortages of critical cancer drugs.

Once the the hospitals provide a list of drugs facing chronic supply shortages, Phlow will decide whether it will seek regulatory approval to produce some or all of the drugs itself or contract out the work, Edwards said. Then, the company will work through long-term purchasing agreements giving Phlow some financial stability that will allow the program to expand.

Drug shortages have been a problem no matter the age of patients for more than a decade, but the needs of children can be more precise than the needs of adults. Initially, the group expects to focus on pain medications, sedatives, nutrition management and blood pressure maintenance, before moving on to other drugs used in the treatment of children's cancers.

Presently, chronic shortages are forcing some children's hospitals to rework their medication delivery pipelines every few days as they're constantly searching for new sources.

In Washington, just four miles from the U.S. Capitol, a children’s hospital is forced at times to call up nearby medical centers to see if they can spare the therapies needed for its young cancer patients.

In Chicago, a drug called epinephrine, which has multiple uses including maintaining blood pressure, can also fall into short supply, sometimes requiring the children’s hospital there to entirely rework its medication delivery protocols every few days.

These occurrences aren’t rare, hospital pharmacists say, and they carry a cost. Treatment in some cases may be delayed, and hospitals can too often find themselves recalibrating doses initially meant for adults, increasing the chance for errors. Now, 11 children’s hospitals are forming a new coalition aimed at blunting the effects of unstable supplies, turning to a company that grew out of the Covid-19 pandemic.

"Our staff, our teams, they’re always in a position of 'Okay, this week we’ve got to keep our eye out to make sure we have a supply," said Kurt Newman, chief executive officer of Children’s National Hospital in Washington, D.C. "It’s not like you can easily take the adult version of that medication and modify it for use in children. That takes a lot of work." The Children’s Hospital Coalition officially kicked off its work on shortages last month. Early on, the group expects to focus on pain medications, sedatives, nutrition management and blood pressure maintenance.

As Bloomberg explains, this market-based solution could help address a shortcoming within the US pharmaceutical market.

One of the hurdles that makes drug shortages such a struggle for pediatric hospitals is the pharmaceutical market itself.

The financial incentives aren’t strong enough to produce vast treatment options for children, which make up just a quarter of the US population. If a pediatric formulation from one manufacturer comes up short, that may be enough to put children’s hospitals on alert.

Pediatric patients also rely heavily on injectable drugs, according to Jenny Elhadary, vice president of clinical services at the Ann & Robert H. Lurie Children’s Hospital in Chicago. "Depending on age, oral pills are just not an option, and many aren’t available in liquid form," she said.

Sterile injectable drugs account for 63% of drug shortages, according to the FDA.

And the problem with re-formulating adult drugs is that hospitals typically eat a loss on most of the product since only a small portion of the active ingredients are used.

Hospital budgets are also another casualty of drug shortages. When pharmacies at children’s hospitals have to use small amounts of adult formulations to make drugs work for children, they rest of that vial they paid full price for might never get used.

"There are a lot of diseases or conditions that might be solvable with the right drug, but they’re not being made because the current companies aren’t doing it," said Newman, with Children’s National. "Once we get through shortages, we want work with Phlow to tackle rare diseases."

However, even brief drug shortages can have life-threatening ramifications. A study published last year found that certain high-risk patients with a common form of childhood leukemia who couldn’t obtain a childhood version of a common drug used in cancer treatment had a 50% higher risk of a poor outcome. "We talk about progress in childhood cancer, but could you imagine a decrease in outcome because we can’t get a drug," said Douglas Hawkins, chairman of the Children’s Oncology Group. "That’s kind of amazing in 2021."

Right now, hospitals around the country can only secure enough of this drug to ensure supplies for between 5 to 7 days. Sometimes, the amount of reserves drops to just one to two days.

"We tend to have anywhere from five to seven days on hand of drugs at any given time," said Eric Balmir, vice president and chief pharmacy officer at Children’s National. But with shortages, "that five to seven days can go down to two or one days, and when we get to that level, we are working furiously not to go down to zero."

The hospital has a task force that meets weekly on the issue, according to Balmir, and there are times, he said, when he dials up nearby hospitals to ask if they have a certain drug to spare. "Sort of like the neighbor saying ‘I need a cup of sugar,'" Balmir said.

One chemotherapy currently in short supply is the only alternative available for about 10% of kids with the most common form of childhood cancer, acute lymphoblastic leukemia, said Douglas Hawkins, chairman of the Children’s Oncology Group, a cancer research organization.

The mobilization effort required to combat COVID has impacted traditional pharmaceutical supply chains in ways that experts didn't anticipate. This likely won't be the last time we see hospitals working together to try and cut costs and increase their bargaining power to ensure they can get their hands on rare drugs without being forced to pay massive markups.

Tyler Durden Tue, 04/06/2021 - 09:55

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Survey Shows Declining Concerns Among Americans About COVID-19

Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat"…

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4 hours ago

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March 11, 2024

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Survey Shows Declining Concerns Among Americans About COVID-19

A new survey reveals that only 20% of Americans view covid-19 as "a major threat" to the health of the US population - a sharp decline from a high of 67% in July 2020.

(SARMDY/Shutterstock)

What's more, the Pew Research Center survey conducted from Feb. 7 to Feb. 11 showed that just 10% of Americans are concerned that they will  catch the disease and require hospitalization.

"This data represents a low ebb of public concern about the virus that reached its height in the summer and fall of 2020, when as many as two-thirds of Americans viewed COVID-19 as a major threat to public health," reads the report, which was published March 7.

According to the survey, half of the participants understand the significance of researchers and healthcare providers in understanding and treating long COVID - however 27% of participants consider this issue less important, while 22% of Americans are unaware of long COVID.

What's more, while Democrats were far more worried than Republicans in the past, that gap has narrowed significantly.

"In the pandemic’s first year, Democrats were routinely about 40 points more likely than Republicans to view the coronavirus as a major threat to the health of the U.S. population. This gap has waned as overall levels of concern have fallen," reads the report.

More via the Epoch Times;

The survey found that three in ten Democrats under 50 have received an updated COVID-19 vaccine, compared with 66 percent of Democrats ages 65 and older.

Moreover, 66 percent of Democrats ages 65 and older have received the updated COVID-19 vaccine, while only 24 percent of Republicans ages 65 and older have done so.

“This 42-point partisan gap is much wider now than at other points since the start of the outbreak. For instance, in August 2021, 93 percent of older Democrats and 78 percent of older Republicans said they had received all the shots needed to be fully vaccinated (a 15-point gap),” it noted.

COVID-19 No Longer an Emergency

The U.S. Centers for Disease Control and Prevention (CDC) recently issued its updated recommendations for the virus, which no longer require people to stay home for five days after testing positive for COVID-19.

The updated guidance recommends that people who contracted a respiratory virus stay home, and they can resume normal activities when their symptoms improve overall and their fever subsides for 24 hours without medication.

“We still must use the commonsense solutions we know work to protect ourselves and others from serious illness from respiratory viruses, this includes vaccination, treatment, and staying home when we get sick,” CDC director Dr. Mandy Cohen said in a statement.

The CDC said that while the virus remains a threat, it is now less likely to cause severe illness because of widespread immunity and improved tools to prevent and treat the disease.

“Importantly, states and countries that have already adjusted recommended isolation times have not seen increased hospitalizations or deaths related to COVID-19,” it stated.

The federal government suspended its free at-home COVID-19 test program on March 8, according to a website set up by the government, following a decrease in COVID-19-related hospitalizations.

According to the CDC, hospitalization rates for COVID-19 and influenza diseases remain “elevated” but are decreasing in some parts of the United States.

Tyler Durden Sun, 03/10/2024 - 22:45

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Rand Paul Teases Senate GOP Leader Run – Musk Says “I Would Support”

Rand Paul Teases Senate GOP Leader Run – Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump…

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March 10, 2024

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Rand Paul Teases Senate GOP Leader Run - Musk Says "I Would Support"

Republican Kentucky Senator Rand Paul on Friday hinted that he may jump into the race to become the next Senate GOP leader, and Elon Musk was quick to support the idea. Republicans must find a successor for periodically malfunctioning Mitch McConnell, who recently announced he'll step down in November, though intending to keep his Senate seat until his term ends in January 2027, when he'd be within weeks of turning 86. 

So far, the announced field consists of two quintessential establishment types: John Cornyn of Texas and John Thune of South Dakota. While John Barrasso's name had been thrown around as one of "The Three Johns" considered top contenders, the Wyoming senator on Tuesday said he'll instead seek the number two slot as party whip. 

Paul used X to tease his potential bid for the position which -- if the GOP takes back the upper chamber in November -- could graduate from Minority Leader to Majority Leader. He started by telling his 5.1 million followers he'd had lots of people asking him about his interest in running...

...then followed up with a poll in which he predictably annihilated Cornyn and Thune, taking a 96% share as of Friday night, with the other two below 2% each. 

Elon Musk was quick to back the idea of Paul as GOP leader, while daring Cornyn and Thune to follow Paul's lead by throwing their names out for consideration by the Twitter-verse X-verse. 

Paul has been a stalwart opponent of security-state mass surveillance, foreign interventionism -- to include shoveling billions of dollars into the proxy war in Ukraine -- and out-of-control spending in general. He demonstrated the latter passion on the Senate floor this week as he ridiculed the latest kick-the-can spending package:   

In February, Paul used Senate rules to force his colleagues into a grueling Super Bowl weekend of votes, as he worked to derail a $95 billion foreign aid bill. "I think we should stay here as long as it takes,” said Paul. “If it takes a week or a month, I’ll force them to stay here to discuss why they think the border of Ukraine is more important than the US border.”

Don't expect a Majority Leader Paul to ditch the filibuster -- he's been a hardy user of the legislative delay tactic. In 2013, he spoke for 13 hours to fight the nomination of John Brennan as CIA director. In 2015, he orated for 10-and-a-half-hours to oppose extension of the Patriot Act. 

Rand Paul amid his 10 1/2 hour filibuster in 2015

Among the general public, Paul is probably best known as Capitol Hill's chief tormentor of Dr. Anthony Fauci, who was director of the National Institute of Allergy and Infectious Disease during the Covid-19 pandemic. Paul says the evidence indicates the virus emerged from China's Wuhan Institute of Virology. He's accused Fauci and other members of the US government public health apparatus of evading questions about their funding of the Chinese lab's "gain of function" research, which takes natural viruses and morphs them into something more dangerous. Paul has pointedly said that Fauci committed perjury in congressional hearings and that he belongs in jail "without question."   

Musk is neither the only nor the first noteworthy figure to back Paul for party leader. Just hours after McConnell announced his upcoming step-down from leadership, independent 2024 presidential candidate Robert F. Kennedy, Jr voiced his support: 

In a testament to the extent to which the establishment recoils at the libertarian-minded Paul, mainstream media outlets -- which have been quick to report on other developments in the majority leader race -- pretended not to notice that Paul had signaled his interest in the job. More than 24 hours after Paul's test-the-waters tweet-fest began, not a single major outlet had brought it to the attention of their audience. 

That may be his strongest endorsement yet. 

Tyler Durden Sun, 03/10/2024 - 20:25

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While “Waiting” For Deporation, Asylum

The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several…

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March 10, 2024

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The Great Replacement Loophole: Illegal Immigrants Score 5-Year Work Benefit While "Waiting" For Deporation, Asylum

Over the past several months we've pointed out that there has  been zero job creation for native-born workers since the summer of 2018...

... and that since Joe Biden was sworn into office, most of the post-pandemic job gains the administration continuously brags about have gone foreign-born (read immigrants, mostly illegal ones) workers.

And while the left might find this data almost as verboten as FBI crime statistics - as it directly supports the so-called "great replacement theory" we're not supposed to discuss - it also coincides with record numbers of illegal crossings into the United States under Biden.

In short, the Biden administration opened the floodgates, 10 million illegal immigrants poured into the country, and most of the post-pandemic "jobs recovery" went to foreign-born workers, of which illegal immigrants represent the largest chunk.

Asylum seekers from Venezuela await work permits on June 28, 2023 (via the Chicago Tribune)

'But Tyler, illegal immigrants can't possibly work in the United States whilst awaiting their asylum hearings,' one might hear from the peanut gallery. On the contrary: ever since Biden reversed a key aspect of Trump's labor policies, all illegal immigrants - even those awaiting deportation proceedings - have been given carte blanche to work while awaiting said proceedings for up to five years...

... something which even Elon Musk was shocked to learn.

Which leads us to another question: recall that the primary concern for the Biden admin for much of 2022 and 2023 was soaring prices, i.e., relentless inflation in general, and rising wages in particular, which in turn prompted even Goldman to admit two years ago that the diabolical wage-price spiral had been unleashed in the US (diabolical, because nothing absent a major economic shock, read recession or depression, can short-circuit it once it is in place).

Well, there is one other thing that can break the wage-price spiral loop: a flood of ultra-cheap illegal immigrant workers. But don't take our word for it: here is Fed Chair Jerome Powell himself during his February 60 Minutes interview:

PELLEY: Why was immigration important?

POWELL: Because, you know, immigrants come in, and they tend to work at a rate that is at or above that for non-immigrants. Immigrants who come to the country tend to be in the workforce at a slightly higher level than native Americans do. But that's largely because of the age difference. They tend to skew younger.

PELLEY: Why is immigration so important to the economy?

POWELL: Well, first of all, immigration policy is not the Fed's job. The immigration policy of the United States is really important and really much under discussion right now, and that's none of our business. We don't set immigration policy. We don't comment on it.

I will say, over time, though, the U.S. economy has benefited from immigration. And, frankly, just in the last, year a big part of the story of the labor market coming back into better balance is immigration returning to levels that were more typical of the pre-pandemic era.

PELLEY: The country needed the workers.

POWELL: It did. And so, that's what's been happening.

Translation: Immigrants work hard, and Americans are lazy. But much more importantly, since illegal immigrants will work for any pay, and since Biden's Department of Homeland Security, via its Citizenship and Immigration Services Agency, has made it so illegal immigrants can work in the US perfectly legally for up to 5 years (if not more), one can argue that the flood of illegals through the southern border has been the primary reason why inflation - or rather mostly wage inflation, that all too critical component of the wage-price spiral  - has moderated in in the past year, when the US labor market suddenly found itself flooded with millions of perfectly eligible workers, who just also happen to be illegal immigrants and thus have zero wage bargaining options.

None of this is to suggest that the relentless flood of immigrants into the US is not also driven by voting and census concerns - something Elon Musk has been pounding the table on in recent weeks, and has gone so far to call it "the biggest corruption of American democracy in the 21st century", but in retrospect, one can also argue that the only modest success the Biden admin has had in the past year - namely bringing inflation down from a torrid 9% annual rate to "only" 3% - has also been due to the millions of illegals he's imported into the country.

We would be remiss if we didn't also note that this so often carries catastrophic short-term consequences for the social fabric of the country (the Laken Riley fiasco being only the latest example), not to mention the far more dire long-term consequences for the future of the US - chief among them the trillions of dollars in debt the US will need to incur to pay for all those new illegal immigrants Democrat voters and low-paid workers. This is on top of the labor revolution that will kick in once AI leads to mass layoffs among high-paying, white-collar jobs, after which all those newly laid off native-born workers hoping to trade down to lower paying (if available) jobs will discover that hardened criminals from Honduras or Guatemala have already taken them, all thanks to Joe Biden.

Tyler Durden Sun, 03/10/2024 - 19:15

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