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Possible Tamoxifen shortage - refill now if you can

TraciInLA's picture
TraciInLA
Posts: 1836
Joined: Jul 2009

I received a letter in today's mail from my mail-order pharmacy (Express Scripts, for Anthem) that there's apparently a "shortage of the active ingredient used to manufacture Tamoxifen products," and warning me that they may not be able to fill prescriptions for Tamoxifen for some unspecified period of time, possibly through April.

Their letter is very vague, vetted-by-their-legal-department, insurance-speak, but I wanted to get the word out to any of you who are on Tamoxifen.  

They urge me to talk with my doctor about an "alternative medication."  Really?  And what would that "alternative medication" be for those of us nowhere near menopause?  There isn't one, Tamoxifen is it.

I have several weeks' worth of pills left, but hurried and placed an order for my 90-day refill after I read the letter, and am waiting to see if they still have some available.  The letter also suggests that local pharmacies may still have stock.

So...if you can, you may want to stop by the pharmacy tonight and refill your prescription right away, in the event that this shortage does happen.

Traci

Clementine_P's picture
Clementine_P
Posts: 363
Joined: Feb 2011

Thank you, Traci!  That is very good to know.  I am going to pick up my refill tomorrow. 

PS, how WEIRD! 

carkris's picture
carkris
Posts: 4518
Joined: Aug 2009

I am a nurse and we have experienced shortages more in the last 5 years than ever. some eds come form plants in the rainforest and the rainforest is being destroyed, etc.. tamoxifen comes form a plant so if it is threatened or in shortage , bummer I only get mine by the month.

mtmom
Posts: 25
Joined: Nov 2013

That is interesting. Thanks for the info. I know the last two months that I have gotten refills I was told the 20mg tabs are not available right now and so I've been getting 10mg tabs. Have to see where this goes.

~Mtmom

CypressCynthia's picture
CypressCynthia
Posts: 3913
Joined: Oct 2009

Most of the shortages that I have experienced as an NP have nothing to do with a shortage of product, but have everything to do with $$$.  Unfortunately, as a drug becomes less expensive and generic to the public, it becomes less profitable to the pharmaceutical companies and fewer companies continue to make the drug. 

"Most drug shortages that occur in the U.S. involve generic medications.4,10 These shortages likely occur because manufacturers have little financial incentive to produce off-patent medications.1,9 At most, only a few manufacturers produce a particular generic drug, so shortages are inevitable.9 Shortages of drug classes containing mostly generic drugs, including anesthetics, antibiotics, and cancer treatments, have tripled since 2006.15 Companies may also decide to discontinue production of a trade-name drug once it comes off-patent, and the need to produce an additional product also strains the capacity of generic drug manufacturers."  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278171/

If the public does not express outrage and this continues without government intervention (and I don't like government intervention either, but the alternative is unthinakable), there is a real potential for hundreds of thousands of lives to be impacted - no matter what the disease or condition.

Over the last two years, I personally experienced shortages of both medications and TPN ingredients.  TPN is the life-saving IV solution which contains protein, vitamins and micro-nutirents so needed for premature infants (and many ill adults).  

Less than 3% of this has to do with a lack of raw materials for the drug.  This is about profit, plain and simple.

camul's picture
camul
Posts: 2012
Joined: Dec 2010

I was reading an article related to all of these "so called" shortages Nd one thing that grabbed my attention is that to keep profits up, the drug companies will make deals with others not to produce the generics for a period of time on a specific med, and they will do the same for them. If there is no competition, they can keep the prices up! This is all at our expense. Just amazes me that this goes on, knowingly, and the fda turns itss head.
Yes it is all about $$$ and it comes at our expense.

disneyfan2008
Posts: 5259
Joined: Oct 2010

I just finished mine in Aug..but most insurances you can't get or pre order until-you run out or close to it.

 

Denise

TraciInLA's picture
TraciInLA
Posts: 1836
Joined: Jul 2009

Just got word from my mail-order pharmacy that they were able to ship my next 90-day prescription, so I hope I'll be covered until this gets resolved.

I, of course, have been googling around about this -- according to a bulletin from the American Society of Health-System Pharmacists and some posts on BreastCancer.org, it looks as though 3 of the manufacturers of Tamoxifen (Teva, Mylan, and Actavis) are all reporting shortages.  It's suspected that Teva, at least, has simply decided to stop manufacturing it.  

Women on BreastCancer.org are reporting that their pharmacies have switched to the manufacturer Watson, which still seems to have stock, and doesn't seem to be reporting any shortages yet.  My pharmacy has always used Teva -- I'm betting that the bottle I get will say "Watson" on it now.

Some women are also reporting that, if they're not able to get the 20 mg tablets, their pharmacies still have stock of the 10 mg ones.  If you have trouble, you may try asking your doctor to write you a new prescription for 2x 10 mg instead of 1x 20 mg.

Traci

 

jessiesmom1's picture
jessiesmom1
Posts: 708
Joined: Jun 2010

I went to the FDA website and found the Current Drug Shortages Index:

http://www.fda.gov/Drugs/DrugSafety/DrugShortages/ucm050792.htm 

You can look up a drug either alphabetically or by therapeutic category. It is very interesting to see what is on there. Tamoxifen is not.

IRENE

Bella Luna's picture
Bella Luna
Posts: 1571
Joined: Aug 2009

Hi All,

It's been a long while since I have posted. Thought I'd jump in to the mix on this blog.

I was told about the shortage a little over six months ago.  They gave me 10mg tablets, told me to take 2 a day.  Tracie how great to hear you can get a 90 day supply, I was told it had to be on a monthly basis.  How scary to hear the insurance compainies are suggesting survivors talk to their doctors about alternative medications.  Holy Smoke!  I hope all who need their meds are getting them.

Double Whammy's picture
Double Whammy
Posts: 2264
Joined: Jun 2010

90 day supply.  No problems mentioned.  Go figure.

Suzanne

TraciInLA's picture
TraciInLA
Posts: 1836
Joined: Jul 2009

After all the scary-letter drama from my insurance company, I also received my 90-day supply with no problem -- and manufactured by Teva, the same manufacturer my mail-order pharmacy has been using all along!

I had my regular appointment with my oncologist last week, and he did say he has a couple of patients like Ines, whose insurance companies are at the moment only able to provide 10-mg tablets.  But he said that's been the only problem he's seen so far.

Traci

 

 

CypressCynthia's picture
CypressCynthia
Posts: 3913
Joined: Oct 2009

Thank you for keeping everyone informed.  I wrote a letter to my congresswoman about this.  Critical shortages of life-saving drugs should not happen beacuse of profit. 

jessiesmom1's picture
jessiesmom1
Posts: 708
Joined: Jun 2010

As of today, the FDA website lists the following oncology drugs on its Current Shortages list:

 

Oncology Daunorubicin Hydrochloride Solution for Injection
Oncology Doxorubicin (Adriamycin) Lyophilized Powder
Oncology Leucovorin Calcium Lyophilized Powder for Injection
Oncology Leuprolide Acetate Injection
Oncology Thiotepa (Thioplex) for Injection
bethsbaby's picture
bethsbaby
Posts: 5
Joined: Apr 2011

I too recieved the letter from express scripts about a shortage.  The "shortage" was a economical problem.  A couple of years ago there were 4 manufacturers of generic tamoxifen.  Watson, Teva, Mylan and Barr.  Now there are only two left Watson and Teva.  The cost of each tablet is between 3 and 11 cents.  Because of the inexpensive cost, there isn't a large profit margin for these manufacturers, so when they need to make cutbacks, it is those low profit drugs that are the first to go.   

I am currently taking the Teva brand, but preferred the mylan brand.  Unfortunately the mylan brand is no longer in production.  I had terrible side effects from the Watson brand.  What I learned is that there is  a range that all generics active ingredients must fall between.  And different brands may have slightly different strenghts and different ingredients.  The active ingredient has to be the same, but the ammount may be slightly different, but the other ingredients can be different.  So ,  if you have trouble with tamoxifen, before you give up on taking it , you may want to request a different brand.  And, since everyone is different, having a variety of manufacturers would be nice, but the almighty dollar may keep that from happening.  It is a shame that we can be madated to buy insurance by our government, but that our government is unable to madate that medications that have been proven to be benificial  be made availiable to patients. 

 

Hope everyone is able to get the medication they need and my your hot flashes be few and far between  :)

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