Stanford's Link described the shortages of paclitaxel as geographically variable and partly dependent on the size and clout of institutions. "Large institutions have multiple suppliers, multiple distributors to work with," he said. "They're likely to have more leverage and more options in terms of getting in a supply of drugs."
But most adult cancer patients in the United States are treated in smaller practices in their communities, he said, which "tend to operate more on an order-as-needed basis." With less leverage and fewer alternate suppliers, he said, "they're really getting killed."
The American Society of Clinical Oncology has been collecting anecdotes to get a feel for some of the impact. "We've heard horror stories where patients have actually gone to another state to get their own supply of the drug," he said.
In response to an ABC News request for comment about their paclitaxel supplies, a dozen major U.S. hospitals and medical centers said they hadn't experienced a shortage. Among them: the Fred Hutchinson Cancer Research Center in Seattle; Duke University in Durham, N.C., the University of Rochester Medical Center in New York; the University of Michigan Comprehensive Cancer Center in Ann Arbor; Maimonides Cancer Center in Brooklyn, N.Y.; Georgetown University's Lombardi Comprehensive Cancer Center in Washington, D.C. and Indiana University-Purdue University in Indianapolis.
Still, some of the largest and most renowned U.S. medical centers reported being short of paclitaxel, along with other important drugs. "In my 25 years as a cancer MD, I have never, never seen this," said Dr. Jay Brooks, chairman of hematology-oncology at the Ochsner Clinic Foundation and Hospital in New Orleans, where 800 doctors and 20 oncologists "work together to shift drugs where needed for patients."
At the University of Medicine and Dentistry of New Jersey, where paclitaxel is "our No. 1 drug," some paclitaxel has been stashed away "and we are continually ordering from various sources to try to maintain a continual supply," said Dr. Lillian Pliner, acting director of hematology/oncology. If the drug becomes unavailable, "we would have to look at alternate treatment protocols."
Dr. Roy B. Jones, professor of medicine at the MD Anderson Cancer Center in Houston, called the shortage "manageable but worrisome," and said his medical center was handling it "with fingers crossed." He said he was aware of "many" chemotherapy drugs in short supply, including four at critically low levels and another 20 that he considered "worrisome."
Beaumont Hospital in Royal Oak, Mich., is paying 3.5 times its usual contract cost for paclitaxel to make sure patient care isn't interrupted, Annette Karageanes, assistant director of its pharmacy supply chain, said Thursday. Paclitaxel was "one of 40 products that we evaluated this morning during our drug shortage meeting," she said.