Supply Chain Shortage: ONCOLOGY TREATMENTS

In the ongoing saga, with supply chain issues across the globe ...

Today, I saw a national news story that told how some medical facilities are experiencing a critical shortage --- for CONTRAST DYE --- used during many diagnostic scans.

Some hospitals have a steady supply, while other places are having to ration supplies and prioritize which situations warrant the use of their dwindling supply.

This shortage of contrast dye was attributed to a shut-down at a manufacturing firm in Shanghai, due to a shut-down ~~~ due to a ripple effect from the pandemic.

It's unbelievable how DELICATE the supply "chain" seems to be - in many critical areas.

Seems the "chain" is more like a delicate THREAD, rather than a forged "chain!"

Many of us here have had scans that have included the use of CONTRAST DYE ~~~ often an ESSENTIAL component used in diagnostic & follow-up imaging and scans.

My best to all ---

C-Y-C-L-O-N-E ••••• # Iowa State University

P.S. --- UPDATE: Thank you to Sr. Sailor for adding a link in his subsequent post, which informs us of a shortage of the newly approved treatment known as LUTETIUM-177, for prostate cancer.

AND
https://www.auntminnie.com/index.aspx?sec=ser&sub=def&pag=dis&itemid=135731

Thank you to Sr. Sailor for the highlighted article above, which also tells us that there's also supply chain snag for the newly approved LUTETIUM-177 treatment components.

We've all been following its recent approval for metastatic prostate cancer, in recent weeks.

The article states it is hoped the supply will be restored in six weeks.

It also stated this will impact the supply for six weeks, INCLUDING the supply needed during ongoing clinical trials.

I'm envisioning large medical campuses ---- such as Mayo Clinic or Emory or M.D. Anderson or Dana-Farber or Siteman --- now facing the news of supply chain issues for the contrast dye used daily in THOUSANDS of diagnostic scans.

Each time I visit Mayo Clinic for follow-up scans, contrast dye is almost invariably used in the process.

There are patients who fly in from all parts of the globe for scans --- with appointments that were booked months ago. I have met fellow patients from faraway countries, when I visit Mayo Clinic.

For someone just getting ready to start LUTETIUM-177 treatments - or who was in the middle of a clinical trial --- this LUTETIUM-177 shortage is critical.

It reminds me of a friend of mine, who was in the middle of chemo infusions - a few years ago. A major hurricane slammed Haiti or Puerto Rico, where an essential chemotherapy component was produced.

His chemo treatments were put on hold, until Dr. Kwon from Mayo Clinic moved "HEAVEN & EARTH" to obtain enough supplies, for his series of treatments. It was a critical situation.

I can't even describe the stress, worrisome thoughts, and anxiety my friend experienced due to that "supply chain" issue.

My best to each & all - and let's hope the medical supply chain becomes strengthened!

CYCLONE --- # Iowa State University

Post Edited (Cyclone-ISU) : 5/19/2022 9:09:07 AM (GMT-6)

Well, the last 20 years or so we have had "just in time supplying." It is the most efficient way to do business. This is the down side.

Mel

One of the selling points of free trade is that it creates dependencies that should, theoretically, prevent any given country from waging war against another. The dependencies create a high cost in a cost/benefit analysis when deciding whether or not to wage war.

Then Russia invaded Ukraine despite the many ties.

Our ties with China are like a million times deeper. Nearly all of our penicillin comes from China for example. What happens if they take a shot at Taiwan?

We have hollowed out our ability to create/build things in the USA and now we are vulnerable.

Mel - Henry Ford had the right idea at the River Rouge plant which was copied in other countries.

Henry Ford’s ultimate goal was to achieve total self-sufficiency by owning, operating and coordinating all the resources needed to produce complete automobiles. His Ford Motor Company once owned 700,000 acres of forest, iron mines and limestone quarries in northern Michigan, Minnesota and Wisconsin. Ford mines covered thousands of acres of coal-rich land in Kentucky, West Virginia and Pennsylvania. Ford even purchased and operated a rubber plantation in Brazil. To bring all these materials to the Rouge, Ford operated a fleet of ore freighters and an entire regional railroad company. Ford’s ambition was never completely realized, but no one has ever come so close on such a grand scale. At no time, for example, did Ford have fewer than 6,000 suppliers serving the Rouge.

Just happened to be reading 1984 again after 50+ years and one basic tenet was that the world was made up of three groups of countries, each of which controlled the means and materials to make everything they needed. Orwell did not see it totally right as China became that country in the end, not the US/Europe group of countries.

As for LU-177 shortages, it's a horrible reality. Also, things I found out about LU-177 during my treatments at UCLA:

* It was made in Italy, shipped to a processing plant in New Jersey, then overnighted to UCLA.
* It had about a 48-hour shelf life when it left NJ
* One batch of the six I had was bad (I guess found in NJ) so two of the four recipients that week at UCLA had to reschedule.
* One treatment I had was late -- we were waiting for Fed Ex to deliver and thought we'd have to reschedule.

So, yes, this was a delicate, time-critical process that if something happened in the supply chain, had real consequences. Here's hoping and praying that Novartis can make this a successful rollout very soon.

Does the USA even know HOW to make anything from "scratch" anymore?

In the small business I work in, we are a manufacturer, who for many years has been heavily tied with several suppliers in Europe (Italy and the Netherlands)--we sold and serviced equipment that they private labeled for us. We have been working towards developing our own versions for several years now, for this very reason. It IS possible, with caveats. Electronic components such as computer chips are nearly all made in Asia. Period.

The bigger issue, as I commented previously, is that with the lifting of anti-trust rules in the US, is consolidation. Where there used to be 5 different manufacturers of similar goods, now there is one. And when that one has a problem, we're all in trouble (the current baby formula situation is a perfect example).

This is the world we're in now. It's been building for a long time. It's not going to reverse anytime soon.

Inventory? We're carrying more inventory now of certain items than we ever did. No choice. Items that we used to be able to get in a week or two are now frequently 2-3 months or longer. So I HAVE TO carry 4X more inventory to keep up with my customers...when I can get it.

I worked in the aerospace/defense sector for the same company for 40 years (now retired). This was VERY high precision spaceflight stuff. about 15 years ago, we were forced to take seminars and try to implement "just-in-time" where stuff arrives just when needed. This was supposed to reduce inventory and carrying costs. I was outspoken that this would not work in this industry.

The reason was when, for whatever reason (your fault, my fault, nobody's fault) an item was not received on time, you have hundreds of people sitting around on overhead because work cannot proceed. You can't go down and get this stuff from your local hardware store. If you have some inventory, you can continue work for awhile. Even if defects are found during processing, rework/fix is a possibility IF YOU HAVE THE PARTS IN INVENTORY.
I realize this is a little different than medicines and dyes that have very short shelf lives, but it still is an example of the morons in upper business management who don't realize what they are doing.

Any update on when shortage will be eliminated?

This unfortunate thread stands as a vivid illustration as to why America must be self-sufficient. We can no longer rely on doing business with other countries - - especially when it comes to critical medical supplies/paraphernalia ( not to forget crude oil, etc.).

And that means using the taxing and other authorities of the U.S. Government to disincentivize manufacturers from moving overseas. America remains the greatest nation on the face of God's green earth. We can do this.

Will we ever learn???

NJ Fred

Post Edited (NJFred) : 7/4/2022 6:01:17 PM (GMT-6)

On the national news, the latest oncology shortages featured were shortages of CARBOPLATIN & CISPLATIN ~ both being common components in blended chemotherapy infusions.

Interesting To Note: The feature stated these two medications are used in 10% to 20% of ALL cancer treatments, overall.

Just another aspect of "supply chain" & shortages ~ impacting oncology patients ...

CYCLONE ~ # Iowa State University