Many hospital patients are being turned away for potentially life-saving injection treatments in what may be the largest U.S. hospital drug shortage in over two decades.
Most drugs in short supply are known as injectables and include sedation medication such as propofol, the popular blood thinner heparin, and hard-hitting chemotherapy drugs like doxorubicin.
"I've been in practice more than 30 years and this is the first time I've encountered shortages that may affect patient care," said Dr. Michael Link, president-elect of the American Society of Clinical Oncology.
Limited manufacturing, lagging production time, and lack of profits from these drugs are contributing to the shortage, according to an August 2010 editorial published in the New England Journal of Medicine. The production cost outweighs the profits for some companies. Since many firms would rather produce cheaper generic drugs, manufacturers are shunning some costly brands.
Doctors at local hospitals are frustrated and many times they're not even informed of the shortage, according to survey results released in September by the Institute for Safe Medication Practices. Of those surveyed, 85 percent said they were given little to no information on how long the shortages would last.
Responses poured in to ABC News' Medical Unit from more than a dozen doctors nationwide, many of whom confirmed they too were experiencing shortages and had to find alternative treatments for some of their patients.
"It has caused us to spend a great deal of physician and pharmacy time developing priority trees to allocate available drug if necessary as well as to scour suppliers for drug shipments," Dr. John Goldberg, pediatric oncologist at the University of Miami School of Medicine wrote in an email response to ABC News' Medical Unit.
And since these medications are mainly housed in hospitals, most patients won't know it might not be available until they really need it.
Mark McKee's doctors have spent 15 years managing his rare abdominal tumor. But in the last year and a half, his tumor grew significantly, so Dr. Craig Howe, McKee's doctor at United Hospital in St. Paul, Minn., upped his treatment to the more aggressive chemotherapy regimen that included doxorubicin.
The regimen seemed to be working, said McKee, 39, of Minneapolis. But last month, the afternoon before he was scheduled for his routine chemotherapy, McKee was told the hospital did not have enough doxorubicin that he needed for his infusion.
Something may be better than nothing, McKee said Howe told him. McKee received a quarter less than the full dose needed to regulate his tumor.
Manufacturing for doxorubicin dropped from three companies to two earlier this year after an FDA warning letter prompted TEVA Pharmaceuticals to stop manufacturing the drug. Meanwhile, the demand for the drug has only increased, according to the American Society of Health-System Pharmacists, which maintains a list of current drug shortages.
In a written statement to ABC News, Bedford Laboratories, one of only two doxorubicin manufacturers, said they are "currently facing manufacturing capacity constraints that are resulting in back orders of some products, including doxorubicin."
According to Howe, many doctors are never told exactly when some of these medications will be available again.